CPT code 46947: Hemorrhoidopexy, stapled technique2026 Medicare rate & RVUs

Medicare pays $379.43 for 46947 nationally in a facility.

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

What 46947 covers

Stapled hemorrhoidopexy treats prolapsing internal hemorrhoidal tissue by removing a circumferential ring of rectal mucosa and submucosa above the hemorrhoids with a circular stapling device, lifting the prolapsed tissue toward its anatomic position. A colorectal or general surgeon typically performs the operation in an operating-room setting for symptomatic internal hemorrhoidal prolapse. This code describes the stapled approach, rather than banding or destruction of individual hemorrhoids.

Report 46947 when the operative technique is stapled hemorrhoidopexy; selection is based on the procedure, not the number of hemorrhoidal columns. The operative note should identify the prolapsing internal hemorrhoids and document the stapled technique and relevant findings. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, 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 46947 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

46947 rates by state

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

How the 46947 rate is calculated

Each of 46947’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.

Payment rules and modifiers for 46947

46947 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

46947 compared with similar codes

How to choose

46945Hemorrhoid ligationOne column, no imaging

Use 46945 for ligation of one internal hemorrhoid. Use 46947 when the surgeon performs stapled hemorrhoidopexy to reposition prolapsing tissue.

46946Hemorrhoid ligationTwo or more, without imaging

46946 reports ligation of two or more internal hemorrhoids. It is not selected for stapled hemorrhoidopexy, regardless of the number of columns treated.

46948Hemorrhoid surgeryDoppler-guided, two or more columns

46948 describes transanal hemorrhoidal dearterialization for multiple hemorrhoids. Choose between it and 46947 according to the operative technique documented.

46260HemorrhoidectomyInternal and external, 2+ groups

46260 describes excisional removal of multiple internal and external hemorrhoidal columns or groups. Code 46947 describes the stapled repositioning approach.

Codes related to 46947

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

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

Open CMS sourceHow we calculate rates