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Surgery for Groin Pain in Athletes

Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Sports Medicine, General Surgery·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

BCBS classifies all surgical treatments for groin pain in athletes (including athletic pubalgia, sports hernia, and core muscle injuries) as investigational and not covered. This affects any surgical procedures for athlete groin pain that would typically use unlisted procedure codes.

Action Required

Action needed
Immediately: Billing team must flag all surgical procedures for groin pain in athletes as non-covered/investigational for BCBS plans. Use unlisted procedure codes 27299, 49659, or 49999 with modifier to indicate investigational status. Inform providers that these surgeries require patient notification of non-coverage and may need cash pay or alternative coverage verification.

Affected Billing Codes

27299
49659
49999

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