CPT code 46948: Hemorrhoid surgery, doppler-guided, two or more columns2026 Medicare rate & RVUs

Medicare pays $445.57 for 46948 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 46948 covers

The surgeon passes a Doppler probe through the anus to locate arterial branches supplying internal hemorrhoids, then places sutures to reduce blood flow. This technique treats two or more internal hemorrhoid columns or groups, often in patients with bleeding or prolapse. Colorectal and general surgeons typically perform it in an operating room or ambulatory surgery center.

Report this code for the transanal dearterialization technique with ultrasound guidance, not for hemorrhoid ligation or stapling performed by another method. The operative note should identify the technique and document treatment of at least two internal columns or groups. Guidance is part of the service. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate; 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 46948 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

46948 rates by state

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

How the 46948 rate is calculated

Each of 46948’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 46948

46948 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

46948 compared with similar codes

How to choose

46946Hemorrhoid ligationTwo or more, without imaging

Choose 46948 when the surgeon performs transanal Doppler-guided dearterialization. Code 46946 describes ligation of two or more columns by another technique.

46945Hemorrhoid ligationOne column, no imaging

Code 46945 is for ligation of one internal hemorrhoid column by another technique; 46948 requires transanal Doppler-guided dearterialization of at least two columns or groups.

46947HemorrhoidopexyStapled technique

Code 46947 describes stapled hemorrhoidopexy for prolapsing internal hemorrhoids, not Doppler-guided dearterialization.

46930Hemorrhoid treatmentThermal energy

Code 46930 describes destruction of internal hemorrhoids. Use 46948 for the specified transanal Doppler-guided dearterialization technique.

Codes related to 46948

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