CPT code 46945: Hemorrhoid ligation, one column, no imaging2026 Medicare rate & RVUs in New Mexico

Reports surgical ligation of one internal hemorrhoid column or group without imaging guidance, rather than destruction, stapling, or treatment of multiple columns.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In New Mexico, Medicare pays $337.16 for 46945 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$337.16Hospital or facility

Check a contract rate as a % of Medicare · 46945 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 46945 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 46945 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 46945 covers

This service treats one internal hemorrhoid column or group by ligation using a method other than rubber-band ligation. A surgeon, commonly a colorectal or general surgeon, performs the procedure in an operating room or another procedural setting, typically using visualization of the anal canal. The code distinguishes a single column or group from treatment of two or more columns and from procedures that destroy or reposition hemorrhoidal tissue.

Report 46945 when the operative documentation supports ligation of one internal hemorrhoid column or group without imaging guidance. Documentation should identify the treated hemorrhoid and describe the ligation technique; use the multiple-column code when two or more columns are treated. The 90-day global period includes 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% reduction. Modifier 50 is inappropriate for this anatomy-specific service. Medicare does not pay an assistant at surgery; co-surgeons and team surgery 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 New Mexico compares for 46945

Across 109 of 109 payment localities, the facility rate for 46945 runs from $310.80 in Arkansas to $446.56 in San Benito County, CA. New Mexico pays $337.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

46945 in New Mexico vs other payment areas
  1. New Mexico · this page$337.16
  2. Los Angeles, CA · California$386.67+$49.51
  3. Washington, DC area · District of Columbia$396.49+$59.33
  4. Miami, FL · Florida$390.63+$53.47
  5. Chicago, IL · Illinois$379.08+$41.92
  6. Manhattan, NY · New York$404.13+$66.97
  7. Alaska · Alaska$414.81+$77.65

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

Every other payment area

46945 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$315.21
ArkansasArkansas—$310.80
ArizonaArizona—$340.90
Bakersfield, CACalifornia—$364.67
Chico, CACalifornia—$362.92
El Centro, CACalifornia—$363.02
Fresno, CACalifornia—$362.92
Hanford, CACalifornia—$362.92

46945 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.

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46945 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 46945 in every payment locality

How the 46945 rate is calculated

Each of 46945’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 · 46945

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.60

3.60 RVUs× 1.000 GPCI

Practice expense6.27

6.27 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

10.4900

Conversion factor

$33.4009

Medicare rate

$350.38

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,639

Code
46945
Physician work
3.60
Practice expense
6.27
Malpractice
0.62

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 46945 in New Mexico
ComponentRVULocality factorAdjusted
Physician work3.60× 1.0003.6000
Practice expense6.27× 0.9175.7496
Malpractice0.62× 1.2010.7446
Total RVUs10.0942
Conversion factor× 33.4009

Facility rate, New Mexico$337.16

Facility: (3.6 × 1 + 6.27 × 0.917 + 0.62 × 1.201) × $33.4009 = $337.16

Open 46945 in the RVU calculator

Payment rules and modifiers for 46945

46945 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46945

Hemorrhoid ligation, one column, no imaging

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 · 46945

Hemorrhoid ligation, one column, no imaging

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

46945 without 51 · national facility

$350.38

Hemorrhoid ligation, one column, no imaging

46945-51 · Second procedure: 50%

$175.19

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

How 46945 has changed in New Mexico

46945 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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, 2020

    RVU20A

    $312.49changed toNo rate

    Held through RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. January 1, 2019

    RVU19A

    $305.28changed to$312.49

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.28 changed to 6.46
    • Malpractice RVU 0.39 changed to 0.41

    Held through RVU19B, RVU19C, RVU19D.

  3. January 1, 2018

    RVU18AR1

    $302.07changed to$305.28

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.21 changed to 6.28
    • Malpractice RVU 0.41 changed to 0.39
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  4. January 1, 2017

    RVU17A

    $300.26changed to$302.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.19 changed to 6.21
    • Malpractice RVU 0.42 changed to 0.41
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  5. January 1, 2016

    RVU16A

    $301.92changed to$300.26

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.22 changed to 6.19
    • Malpractice RVU 0.41 changed to 0.42

    Held through RVU16B, RVU16C, RVU16D.

  6. July 1, 2015

    RVU15C

    $300.42changed to$301.92

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  7. January 1, 2015

    RVU15A

    $291.05changed to$300.42

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.02 changed to 6.22
    • Malpractice RVU 0.36 changed to 0.41
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  8. January 1, 2014

    RVU14A

    $301.87changed to$291.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.86 changed to 6.02
    • Malpractice RVU 0.38 changed to 0.36
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  9. January 1, 2013

    RVU13AR

    Earliest loaded release: $301.87

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$337.16RVU26D
2026-07-01Not available in this setting$337.16RVU26C
2026-04-01Not available in this setting$337.16RVU26B
2026-01-01Not available in this setting$337.16RVU26A
2025-10-01Not available in this setting$321.82RVU25D
2025-07-01Not available in this setting$321.82RVU25C
2025-04-01Not available in this setting$321.82RVU25B
2025-01-01Not available in this setting$321.82RVU25A
2024-10-01Not available in this setting$327.46RVU24D
2024-07-01Not available in this setting$327.46RVU24C
2024-04-01Not available in this setting$327.46RVU24B
2024-03-09Not available in this setting$327.46RVU24AR
2024-01-01Not available in this setting$322.12RVU24A
2023-10-01Not available in this setting$329.06RVU23D
2023-07-01Not available in this setting$329.06RVU23C
2023-04-01Not available in this setting$329.06RVU23B
2023-01-01Not available in this setting$329.06RVU23A
2022-10-01Not available in this setting$333.92RVU22D
2022-07-01Not available in this setting$333.92RVU22C
2022-04-01Not available in this setting$333.92RVU22B
2022-01-01Not available in this setting$333.92RVU22A
2021-10-01Not available in this setting$333.97RVU21D
2021-07-01Not available in this setting$333.97RVU21C
2021-04-01Not available in this setting$333.97RVU21B
2021-01-01Not available in this setting$333.97RVU21A
2020-10-01Not available in this setting$334.62RVU20D
2020-07-01Not available in this setting$334.62RVU20C
2020-04-01Not available in this setting$334.62RVU20B
2020-01-01Not available in this setting$334.62RVU20A
2019-10-01$312.49$228.18RVU19D
2019-07-01$312.49$228.18RVU19C
2019-04-01$312.49$228.18RVU19B
2019-01-01$312.49$228.18RVU19A
2018-10-01$305.28$226.04RVU18D
2018-07-01$305.28$226.04RVU18C
2018-04-01$305.28$226.04RVU18B
2018-01-01$305.28$226.04RVU18AR1
2017-10-01$302.07$225.14RVU17D
2017-07-01$302.07$225.14RVU17C
2017-04-01$302.07$225.14RVU17B
2017-01-01$302.07$225.14RVU17A
2016-10-01$300.26$223.60RVU16D
2016-07-01$300.26$223.60RVU16C
2016-04-01$300.26$223.60RVU16B
2016-01-01$300.26$223.60RVU16A
2015-10-01$301.92$224.32RVU15D
2015-07-01$301.92$224.32RVU15C
2015-04-01$300.42$223.20RVU15B
2015-01-01$300.42$223.20RVU15A
2014-10-01$291.05$217.72RVU14D
2014-07-01$291.05$217.72RVU14C
2014-04-01$291.05$217.72RVU14B
2014-01-01$291.05$217.72RVU14A
2013-10-01$301.87$222.09RVU13D
2013-07-01$301.87$222.09RVU13C
2013-04-01$301.87$222.09RVU13B
2013-01-01$301.87$222.09RVU13AR

Price 46945 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

46945 billing questions

When should 46945 be used instead of 46946?

Use 46945 for ligation of one internal hemorrhoid column or group. When two or more columns are treated, use 46946.

How does this differ from 46930?

46945 describes ligation of an internal hemorrhoid column or group. 46930 is for destruction of internal hemorrhoids, a different treatment method.

What documentation supports reporting 46945?

The operative note should identify the internal hemorrhoid treated, support that one column or group was ligated, and describe the method used without imaging guidance.

Can modifier 50 be reported?

No. The anatomy and service descriptor make bilateral adjustment inappropriate for 46945.

How are related postoperative visits handled?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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.

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 46945PPRRVU2026_Oct_nonQPP.csv, line 5,639 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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