CPT code 49495 describes surgical repair of an initial, reducible inguinal hernia in infants under six months of age, and may include excision of an associated hydrocele. This pediatric procedure is clinically important because early repair can prevent incarceration and potential complications, and because timing relative to prematurity (up to 50 weeks post-conception) affects eligibility for this specific code. Nationally, 49495 is relevant to pediatric surgeons, hospitals, ambulatory surgical centers, and payers that cover infant surgical services.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical settings of care, plus guidance on the types of benchmarks and policy topics commonly associated with this code: utilization patterns for early-life hernia repair, payer coverage nuances for infants born premature versus full-term, site-of-service considerations (hospital OR vs outpatient surgical center), and common billing considerations for procedures that include hydrocele excision. Data not available in the input is noted where relevant. The publication aims to inform billing staff, clinical coders, and policy analysts about the scope and practical implications of CPT code 49495 in a national context.