CPT code 46255: Hemorrhoidectomy, one internal and external group2026 Medicare rate & RVUs
Reports excision of one hemorrhoid group involving both internal and external tissue, typically when a surgeon removes the combined disease surgically.
Medicare pays $580.84 for 46255 nationally in the office and $350.71 in a hospital or facility. Local office rates run $511.28–$756.36.
Medicare rate · 46255
Hemorrhoidectomy, one internal and external group
- Work RVUs
- 4.84
- Total RVUs
- 17.39
- Global days
- 090
National rate · 2026
$580.84
Office setting, before claim adjustments.
See every locality for 46255 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 10 sections
What 46255 covers
A surgeon excises one group of hemorrhoidal tissue that has both internal and external components. The procedure is commonly performed by a colorectal or general surgeon in an operating room or other surgical setting. The defining distinction is one combined group, rather than external-only disease or multiple groups of mixed internal and external hemorrhoids.
The operative report should support removal of both components and identify the extent as a single group or column. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 46255 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$511.28 to $756.36
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $519.05 | $317.69 |
| Alaska | $673.30 | $428.20 |
| Arizona | $564.41 | $341.41 |
| Arkansas | $511.28 | $313.60 |
| Atlanta, GA | $593.66 | $359.84 |
| Austin, TX | $600.25 | $356.77 |
| Bakersfield, CA | $609.35 | $357.13 |
| Baltimore area, MD | $619.01 | $372.08 |
| Beaumont, TX | $543.69 | $334.27 |
| Brazoria, TX | $571.95 | $343.89 |
| Chicago, IL | $623.28 | $392.00 |
| Chico, CA | $606.81 | $354.59 |
| Colorado | $601.01 | $356.15 |
| Connecticut | $620.39 | $372.54 |
| Dallas, TX | $576.43 | $347.21 |
| Delaware | $573.91 | $346.54 |
| Detroit, MI | $588.08 | $366.01 |
| East St. Louis, IL | $580.56 | $368.84 |
| El Centro, CA | $606.96 | $354.74 |
| Fort Lauderdale, FL | $610.45 | $377.33 |
| Fort Worth, TX | $572.93 | $346.02 |
| Fresno, CA | $606.81 | $354.59 |
| Galveston, TX | $574.19 | $345.66 |
| Hanford, CA | $606.81 | $354.59 |
| Hawaii, Guam, HI | $621.31 | $359.65 |
| Houston, TX | $590.84 | $362.32 |
| Idaho | $533.72 | $322.00 |
| Indiana | $536.84 | $323.50 |
| Iowa | $529.47 | $318.90 |
| Kansas | $528.44 | $320.40 |
| Kentucky | $535.10 | $330.52 |
| King County, WA | $671.62 | $389.24 |
| Los Angeles, CA | $648.40 | $376.16 |
| Madera, CA | $606.81 | $354.59 |
| Manhattan, NY | $671.98 | $404.57 |
| Marin County, CA | $739.16 | $414.67 |
| Merced, CA | $606.81 | $354.59 |
| Metropolitan Boston, MA | $659.55 | $384.77 |
| Metropolitan Kansas City, MO | $556.43 | $340.33 |
| Metropolitan Philadelphia, PA | $605.56 | $365.99 |
| Metropolitan St. Louis, MO | $562.24 | $343.15 |
| Miami, FL | $643.26 | $403.69 |
| Minnesota | $570.72 | $333.91 |
| Mississippi | $518.87 | $320.72 |
| Modesto, CA | $606.81 | $354.59 |
| Montana | $580.78 | $350.65 |
| Napa, CA | $699.71 | $396.39 |
| Nebraska | $532.00 | $319.59 |
| Nevada | $576.15 | $345.79 |
| New Hampshire | $592.98 | $353.41 |
| New Mexico | $554.68 | $343.65 |
| New Orleans, LA | $562.04 | $345.48 |
| North Carolina | $543.82 | $329.11 |
| North Dakota | $562.79 | $332.65 |
| Northern New Jersey | $655.30 | $388.35 |
| NYC suburbs and Long Island, NY | $690.72 | $417.09 |
| Ohio | $547.26 | $337.15 |
| Oklahoma | $532.46 | $326.96 |
| Oxnard, CA | $644.67 | $372.65 |
| Portland, OR | $618.80 | $363.13 |
| Poughkeepsie and northern NYC suburbs, NY | $631.43 | $379.44 |
| Puerto Rico | $584.66 | $352.00 |
| Queens, NY | $675.38 | $403.37 |
| Redding, CA | $606.81 | $354.59 |
| Rest of California | $606.81 | $354.59 |
| Rest of Florida | $579.02 | $359.02 |
| Rest of Georgia | $544.69 | $339.41 |
| Rest of Illinois | $564.13 | $354.02 |
| Rest of Louisiana | $534.85 | $331.19 |
| Rest of Maine | $538.25 | $326.53 |
| Rest of Maryland | $584.63 | $351.74 |
| Rest of Massachusetts | $597.86 | $355.53 |
| Rest of Michigan | $550.94 | $340.83 |
| Rest of Missouri | $526.40 | $328.02 |
| Rest of New Jersey | $626.02 | $374.72 |
| Rest of New York | $552.38 | $333.75 |
| Rest of Oregon | $570.26 | $341.05 |
| Rest of Pennsylvania | $547.29 | $336.03 |
| Rest of Texas | $558.07 | $339.67 |
| Rest of Washington | $596.28 | $353.96 |
| Rhode Island | $593.46 | $355.73 |
| Riverside, CA | $616.61 | $364.38 |
| Sacramento, CA | $635.93 | $368.29 |
| Salinas, CA | $633.57 | $366.84 |
| San Benito County, CA | $756.36 | $424.51 |
| San Diego, CA | $647.97 | $372.73 |
| San Francisco, CA | $738.12 | $413.64 |
| San Luis Obispo, CA | $623.53 | $361.41 |
| Santa Clara County, CA | $752.14 | $420.29 |
| Santa Cruz, CA | $653.72 | $374.11 |
| Santa Maria, CA | $635.80 | $367.47 |
| Santa Rosa, CA | $660.23 | $377.63 |
| South Carolina | $546.73 | $334.09 |
| South Dakota | $560.66 | $330.53 |
| Southern Maine, ME | $566.13 | $338.07 |
| Stockton, CA | $606.81 | $354.59 |
| Suburban Chicago, IL | $615.94 | $379.59 |
| Tennessee | $531.39 | $322.20 |
| Utah | $554.41 | $338.09 |
| Vallejo, CA | $698.22 | $394.90 |
| Vermont | $561.94 | $334.11 |
| Virgin Islands, VI | $584.66 | $352.00 |
| Virginia | $565.30 | $339.08 |
| Visalia, CA | $606.81 | $354.59 |
| Washington, DC area | $662.21 | $391.11 |
| West Virginia | $543.01 | $343.03 |
| Wisconsin | $543.48 | $323.01 |
| Wyoming | $572.94 | $342.81 |
| Yuba City, CA | $606.81 | $354.59 |
46255 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$511.28
$681.59
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $673.30 | 1 |
| AL | $519.05 | 1 |
| AR | $511.28 | 1 |
| AZ | $564.41 | 1 |
| CA | $606.81–$756.36 | 29 |
| CO | $601.01 | 1 |
| CT | $620.39 | 1 |
| DC | $662.21 | 1 |
| DE | $573.91 | 1 |
| FL | $579.02–$643.26 | 3 |
| GA | $544.69–$593.66 | 2 |
| GU | $621.31 | 1 |
| HI | $621.31 | 1 |
| IA | $529.47 | 1 |
| ID | $533.72 | 1 |
| IL | $564.13–$623.28 | 4 |
| IN | $536.84 | 1 |
| KS | $528.44 | 1 |
| KY | $535.10 | 1 |
| LA | $534.85–$562.04 | 2 |
| MA | $597.86–$659.55 | 2 |
| MD | $584.63–$662.21 | 3 |
| ME | $538.25–$566.13 | 2 |
| MI | $550.94–$588.08 | 2 |
| MN | $570.72 | 1 |
| MO | $526.40–$562.24 | 3 |
| MS | $518.87 | 1 |
| MT | $580.78 | 1 |
| NC | $543.82 | 1 |
| ND | $562.79 | 1 |
| NE | $532.00 | 1 |
| NH | $592.98 | 1 |
| NJ | $626.02–$655.30 | 2 |
| NM | $554.68 | 1 |
| NV | $576.15 | 1 |
| NY | $552.38–$690.72 | 5 |
| OH | $547.26 | 1 |
| OK | $532.46 | 1 |
| OR | $570.26–$618.80 | 2 |
| PA | $547.29–$605.56 | 2 |
| PR | $584.66 | 1 |
| RI | $593.46 | 1 |
| SC | $546.73 | 1 |
| SD | $560.66 | 1 |
| TN | $531.39 | 1 |
| TX | $543.69–$600.25 | 8 |
| UT | $554.41 | 1 |
| VA | $565.30–$662.21 | 2 |
| VI | $584.66 | 1 |
| VT | $561.94 | 1 |
| WA | $596.28–$671.62 | 2 |
| WI | $543.48 | 1 |
| WV | $543.01 | 1 |
| WY | $572.94 | 1 |
How the 46255 rate is calculated
Each of 46255’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 46255
RVUs × geographic indexes × conversion factor
Work4.84
4.84 RVUs× 1.000 GPCI
Practice expense11.64
11.64 RVUs× 1.000 GPCI
Malpractice0.91
0.91 RVUs× 1.000 GPCI
Adjusted RVUs
17.3900
Conversion factor
$33.4009
Medicare rate
$580.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46255
46255 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46255
Hemorrhoidectomy, one internal and external group
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 46255
Hemorrhoidectomy, one internal and external group
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
46255 without 51 · national office
$580.84
Hemorrhoidectomy, one internal and external group
46255-51 · Second procedure: 50%
$290.42
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
46255 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46260HemorrhoidectomyInternal and external, 2+ groups
- Use 46255 when one mixed internal-external group is excised; use 46260 when multiple such groups are removed.
- 46250HemorrhoidectomyExternal, two or more groups
- 46250 is for excision of multiple external hemorrhoid groups. 46255 requires a single group with both internal and external tissue.
- 46257HemorrhoidectomyOne group with fissurectomy
- Both involve one mixed hemorrhoid group, but 46257 also includes fissurectomy.
- 46221Hemorrhoid ligationRubber-band technique
- 46221 reports hemorrhoid ligation rather than excision of a mixed internal-external group.
46255 billing questions
How does this differ from 46260?
46255 is for one group containing internal and external hemorrhoidal tissue. 46260 is for excision of multiple groups involving both.
Can 46255 be used for external hemorrhoids only?
No. This code represents excision of a group with both internal and external components; 46250 describes excision of multiple external groups.
Is modifier 50 appropriate?
No. CMS identifies bilateral adjustment as inapplicable because the descriptor or anatomy makes modifier 50 inappropriate.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 46255 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist