When I checked the CCI, it stated no bundling issues exist for 11008 and 49568. In fact the notes in CPT state: When insertion of mesh is used for closure, use 49568. So you should be able to bill these together and you shouldn't need a modifier, except for the return to the operating room (78/79 which ever is appropriate for your situation). I put all the codes you mentioned into the CCI and it stated that no bundling issues exist. (44640, 49568, 11008 & 10180)
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