CPT code 46947: Hemorrhoidopexy, stapled technique2026 Medicare rate & RVUs in Texas
Reports stapled repositioning of prolapsing internal hemorrhoidal tissue, typically performed surgically for symptomatic internal hemorrhoidal prolapse.
CMS doesn’t publish an office rate for 46947 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $384.28 |
| Beaumont, TX | Unavailable | $362.38 |
| Brazoria, TX | Unavailable | $370.50 |
| Dallas, TX | Unavailable | $374.65 |
| Fort Worth, TX | Unavailable | $373.61 |
| Galveston, TX | Unavailable | $372.78 |
| Houston, TX | Unavailable | $395.11 |
| Rest of Texas | Unavailable | $367.46 |
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.
How the rate is built · 46947
RVUs × geographic indexes × conversion factor
Work5.43
5.43 RVUs× 1.000 GPCI
Practice expense4.71
4.71 RVUs× 1.000 GPCI
Malpractice1.22
1.22 RVUs× 1.000 GPCI
Adjusted RVUs
11.3600
Conversion factor
$33.4009
Medicare rate
$379.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46947
46947 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46947
Hemorrhoidopexy, stapled technique
| 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 · 46947
Hemorrhoidopexy, stapled technique
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
46947 without 51 · national facility
$379.43
Hemorrhoidopexy, stapled technique
46947-51 · Second procedure: 50%
$189.72
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%).
46947 compared with similar codes
Compare codes · National
5 codes, side by side
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.
46947 billing questions
How does 46947 differ from hemorrhoid ligation codes 46945 and 46946?
46947 is for stapled hemorrhoidopexy to reposition prolapsing internal tissue. Codes 46945 and 46946 describe ligation of internal hemorrhoids and distinguish one hemorrhoid from two or more.
Should 46947 be selected based on the number of hemorrhoidal columns?
No. Select 46947 based on the stapled hemorrhoidopexy technique, not a column count. The operative note should support that technique.
Are related postoperative visits separately reported?
Related postoperative care is included in the 90-day global period, along with the day-before preoperative visit.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
How does 46947 differ from excisional hemorrhoidectomy?
46947 describes stapled repositioning of prolapsing internal tissue. Codes such as 46255 and 46260 describe excisional hemorrhoidectomy, including removal of internal and external hemorrhoidal tissue.
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
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