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CPT code 46255: Hemorrhoidectomy, one internal and external group2026 Medicare rate & RVUs in Nebraska

Reports excision of one hemorrhoid group involving both internal and external tissue, typically when a surgeon removes the combined disease surgically.

CMS RVU26DEffective Oct 1, 2026One payment locality3.8K Medicare services in 2024

In Nebraska, Medicare pays $532.00 for 46255 in the office and $319.59 when it’s performed in a hospital or facility.

$532.00Office (non-facility)
$319.59Hospital or facility
−8.4%vs the national office rate ($580.84)

Check a contract rate as a % of Medicare · 46255 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 46255 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nebraska
  2. What 46255 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Nebraska compares for 46255

Across 109 of 109 payment localities, the office rate for 46255 runs from $511.28 in Arkansas to $756.36 in San Benito County, CA. Nebraska pays $532.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

46255 in Nebraska vs other payment areas
  1. Nebraska · this page$532.00
  2. Los Angeles, CA · California$648.40+$116.40
  3. Washington, DC area · District of Columbia$662.21+$130.21
  4. Miami, FL · Florida$643.26+$111.26
  5. Chicago, IL · Illinois$623.28+$91.28
  6. Manhattan, NY · New York$671.98+$139.98
  7. Alaska · Alaska$673.30+$141.30

Other areas in Nebraska first, then benchmark localities. Bars start at $0.

Every other payment area

46255 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$519.05$317.69
ArkansasArkansas$511.28$313.60
ArizonaArizona$564.41$341.41
Bakersfield, CACalifornia$609.35$357.13
Chico, CACalifornia$606.81$354.59
El Centro, CACalifornia$606.96$354.74
Fresno, CACalifornia$606.81$354.59
Hanford, CACalifornia$606.81$354.59

46255 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
46255 office rate range by state
State / territoryOffice rate rangeLocalities
AK$673.301
AL$519.051
AR$511.281
AZ$564.411
CA$606.81–$756.3629
CO$601.011
CT$620.391
DC$662.211
DE$573.911
FL$579.02–$643.263
GA$544.69–$593.662
GU$621.311
HI$621.311
IA$529.471
ID$533.721
IL$564.13–$623.284
IN$536.841
KS$528.441
KY$535.101
LA$534.85–$562.042
MA$597.86–$659.552
MD$584.63–$662.213
ME$538.25–$566.132
MI$550.94–$588.082
MN$570.721
MO$526.40–$562.243
MS$518.871
MT$580.781
NC$543.821
ND$562.791
NE$532.001
NH$592.981
NJ$626.02–$655.302
NM$554.681
NV$576.151
NY$552.38–$690.725
OH$547.261
OK$532.461
OR$570.26–$618.802
PA$547.29–$605.562
PR$584.661
RI$593.461
SC$546.731
SD$560.661
TN$531.391
TX$543.69–$600.258
UT$554.411
VA$565.30–$662.212
VI$584.661
VT$561.941
WA$596.28–$671.622
WI$543.481
WV$543.011
WY$572.941

See 46255 in every payment locality

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

Office or facility?

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.

The exact Nebraska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,584

Code
46255
Physician work
4.84
Practice expense
11.64
Malpractice
0.91

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office calculation for 46255 in Nebraska
ComponentRVULocality factorAdjusted
Physician work4.84× 1.0004.8400
Practice expense11.64× 0.92310.7437
Malpractice0.91× 0.3780.3440
Total RVUs15.9277
Conversion factor× 33.4009

Office rate, Nebraska$532.00

Office: (4.84 × 1 + 11.64 × 0.923 + 0.91 × 0.378) × $33.4009 = $532.00

Facility: (4.84 × 1 + 4.75 × 0.923 + 0.91 × 0.378) × $33.4009 = $319.59

Open 46255 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

Codes related to 46255

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 46255
CodeHow it relatesOffice range, Nebraska
Same family
46260Hemorrhoidectomy, internal and external, 2+ groupsExcision of multiple groups involving internal and external hemorrhoids.No office rate
46257Hemorrhoidectomy, one group with fissurectomyOne mixed hemorrhoid group treated with concurrent fissurectomy.No office rate
46258Hemorrhoidectomy, single group with fistulectomyOne mixed hemorrhoid group treated with concurrent fistula surgery.No office rate
46250Hemorrhoidectomy, external, two or more groupsExcision of multiple external hemorrhoid groups without the mixed internal-external description.$490.78
Used instead
46221Hemorrhoid ligation, rubber-band techniqueLigation may be used for internal hemorrhoids when excision of a mixed group is not performed.$299.95

How 46255 has changed in Nebraska

46255 · Office / nonfacility

$532.00

Effective 2026-10-01

The base rate is $71.33 higher than on 2025-10-01, moving from $460.67 to $532.00 (15.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $460.67changed to$532.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.96 changed to 4.84
    • Practice expense RVU 9.83 changed to 11.64
    • Malpractice RVU 0.88 changed to 0.91
    • Practice expense GPCI 0.917 changed to 0.923
    • Malpractice GPCI 0.304 changed to 0.378

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $472.44changed to$460.67

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.76 changed to 9.83
    • Malpractice RVU 0.93 changed to 0.88

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $464.73changed to$472.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $480.20changed to$464.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.82 changed to 9.76
    • Malpractice RVU 0.91 changed to 0.93
    • Practice expense GPCI 0.913 changed to 0.917
    • Malpractice GPCI 0.269 changed to 0.304

  5. January 1, 2023

    RVU23A

    $489.98changed to$480.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.89 changed to 9.82
    • Malpractice RVU 0.93 changed to 0.91
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.235 changed to 0.269

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $493.56changed to$489.98

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.88 changed to 9.89
    • Malpractice RVU 0.91 changed to 0.93

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $483.22changed to$493.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.99 changed to 9.88
    • Malpractice RVU 0.93 changed to 0.91
    • Practice expense GPCI 0.909 changed to 0.908
    • Malpractice GPCI 0.277 changed to 0.235

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $477.60changed to$483.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.77 changed to 8.99
    • Malpractice RVU 0.98 changed to 0.93
    • Practice expense GPCI 0.910 changed to 0.909
    • Malpractice GPCI 0.318 changed to 0.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $472.82changed to$477.60

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.64 changed to 8.77

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $468.69changed to$472.82

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.54 changed to 8.64
    • Malpractice RVU 0.99 changed to 0.98
    • Practice expense GPCI 0.909 changed to 0.910
    • Malpractice GPCI 0.340 changed to 0.318

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $467.99changed to$468.69

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.53 changed to 8.54
    • Malpractice RVU 1.01 changed to 0.99
    • Practice expense GPCI 0.908 changed to 0.909
    • Malpractice GPCI 0.362 changed to 0.340

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $471.58changed to$467.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.60 changed to 8.53
    • Malpractice RVU 0.98 changed to 1.01

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $469.23changed to$471.58

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $461.13changed to$469.23

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.39 changed to 8.60
    • Malpractice RVU 0.91 changed to 0.98
    • Practice expense GPCI 0.906 changed to 0.908
    • Malpractice GPCI 0.342 changed to 0.362

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $470.12changed to$461.13

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.46 changed to 8.39
    • Malpractice RVU 0.95 changed to 0.91
    • Practice expense GPCI 0.904 changed to 0.906
    • Malpractice GPCI 0.322 changed to 0.342

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $470.12

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$532.00$319.59RVU26D
2026-07-01$532.00$319.59RVU26C
2026-04-01$532.00$319.59RVU26B
2026-01-01$532.00$319.59RVU26A
2025-10-01$460.67$315.92RVU25D
2025-07-01$460.67$315.92RVU25C
2025-04-01$460.67$315.92RVU25B
2025-01-01$460.67$315.92RVU25A
2024-10-01$472.44$321.95RVU24D
2024-07-01$472.44$321.95RVU24C
2024-04-01$472.44$321.95RVU24B
2024-03-09$472.44$321.95RVU24AR
2024-01-01$464.73$316.70RVU24A
2023-10-01$480.20$324.88RVU23D
2023-07-01$480.20$324.88RVU23C
2023-04-01$480.20$324.88RVU23B
2023-01-01$480.20$324.88RVU23A
2022-10-01$489.98$329.09RVU22D
2022-07-01$489.98$329.09RVU22C
2022-04-01$489.98$329.09RVU22B
2022-01-01$489.98$329.09RVU22A
2021-10-01$493.56$329.44RVU21D
2021-07-01$493.56$329.44RVU21C
2021-04-01$493.56$329.44RVU21B
2021-01-01$493.56$329.44RVU21A
2020-10-01$483.22$332.97RVU20D
2020-07-01$483.22$332.97RVU20C
2020-04-01$483.22$332.97RVU20B
2020-01-01$483.22$332.97RVU20A
2019-10-01$477.60$331.66RVU19D
2019-07-01$477.60$331.66RVU19C
2019-04-01$477.60$331.66RVU19B
2019-01-01$477.60$331.66RVU19A
2018-10-01$472.82$329.66RVU18D
2018-07-01$472.82$329.66RVU18C
2018-04-01$472.82$329.66RVU18B
2018-01-01$472.82$329.66RVU18AR1
2017-10-01$468.69$328.74RVU17D
2017-07-01$468.69$328.74RVU17C
2017-04-01$468.69$328.74RVU17B
2017-01-01$468.69$328.74RVU17A
2016-10-01$467.99$328.52RVU16D
2016-07-01$467.99$328.52RVU16C
2016-04-01$467.99$328.52RVU16B
2016-01-01$467.99$328.52RVU16A
2015-10-01$471.58$329.65RVU15D
2015-07-01$471.58$329.65RVU15C
2015-04-01$469.23$328.01RVU15B
2015-01-01$469.23$328.01RVU15A
2014-10-01$461.13$324.82RVU14D
2014-07-01$461.13$324.82RVU14C
2014-04-01$461.13$324.82RVU14B
2014-01-01$461.13$324.82RVU14A
2013-10-01$470.12$322.80RVU13D
2013-07-01$470.12$322.80RVU13C
2013-04-01$470.12$322.80RVU13B
2013-01-01$470.12$322.80RVU13AR

Price 46255 for an earlier date of service

Where the Nebraska rate applies

Nebraska is a Medicare payment area, not a city. Our Census mapping connects it to 593 cities and communities in Nebraska. Some span more than one payment area; confirm with the service ZIP.

  • Abie
  • Adams
  • Agnew
  • Ainsworth
  • Albion
  • Alda
  • Alexandria
  • Allen

Browse all communities in Nebraska

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
RVUs for 46255PPRRVU2026_Oct_nonQPP.csv, line 5,584 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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