CPT code 46948: Hemorrhoid surgery, doppler-guided, two or more columns2026 Medicare rate & RVUs in Colorado
Reports transanal Doppler-guided surgery to reduce blood flow to two or more internal hemorrhoid columns or groups during one operative session.
In Colorado, Medicare pays $454.35 for 46948 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 46948 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Colorado compares for 46948
Across 109 of 109 payment localities, the facility rate for 46948 runs from $395.79 in Arkansas to $549.31 in San Benito County, CA. Colorado pays $454.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Colorado · this page$454.35
- Los Angeles, CA · California$482.46+$28.11
- Washington, DC area · District of Columbia$500.02+$45.67
- Miami, FL · Florida$510.57+$56.22
- Chicago, IL · Illinois$495.12+$40.77
- Manhattan, NY · New York$515.41+$61.06
- Alaska · Alaska$534.71+$80.36
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $401.29 |
| ArkansasArkansas | — | $395.79 |
| ArizonaArizona | — | $433.26 |
| Bakersfield, CACalifornia | — | $456.65 |
| Chico, CACalifornia | — | $453.63 |
| El Centro, CACalifornia | — | $453.81 |
| Fresno, CACalifornia | — | $453.63 |
| Hanford, CACalifornia | — | $453.63 |
| Madera, CACalifornia | — | $453.63 |
| Merced, CACalifornia | — | $453.63 |
| Modesto, CACalifornia | — | $453.63 |
| Napa, CACalifornia | — | $511.52 |
| Oxnard, CACalifornia | — | $478.38 |
| Redding, CACalifornia | — | $453.63 |
| Rest of CaliforniaCalifornia | — | $453.63 |
| Riverside, CACalifornia | — | $465.35 |
| Sacramento, CACalifornia | — | $472.33 |
| Salinas, CACalifornia | — | $470.52 |
| San Diego, CACalifornia | — | $478.98 |
| Marin County, CACalifornia | — | $536.50 |
| San Francisco, CACalifornia | — | $535.26 |
| San Benito County, CACalifornia | — | $549.31 |
| Santa Clara County, CACalifornia | — | $544.25 |
| San Luis Obispo, CACalifornia | — | $463.42 |
| Santa Cruz, CACalifornia | — | $481.46 |
| Santa Maria, CACalifornia | — | $471.57 |
| Santa Rosa, CACalifornia | — | $486.05 |
| Stockton, CACalifornia | — | $453.63 |
| Vallejo, CACalifornia | — | $509.74 |
| Visalia, CACalifornia | — | $453.63 |
| Yuba City, CACalifornia | — | $453.63 |
| ConnecticutConnecticut | — | $474.38 |
| DelawareDelaware | — | $440.06 |
| Fort Lauderdale, FLFlorida | — | $477.95 |
| Rest of FloridaFlorida | — | $453.86 |
| Atlanta, GAGeorgia | — | $457.07 |
| Rest of GeorgiaGeorgia | — | $427.96 |
| Hawaii, Guam, HIHawaii | — | $461.45 |
| IowaIowa | — | $404.25 |
| IdahoIdaho | — | $408.16 |
| East St. Louis, ILIllinois | — | $464.26 |
| Rest of IllinoisIllinois | — | $446.25 |
| Suburban Chicago, ILIllinois | — | $481.09 |
| IndianaIndiana | — | $410.23 |
| KansasKansas | — | $405.64 |
| KentuckyKentucky | — | $417.19 |
| New Orleans, LALouisiana | — | $437.08 |
| Rest of LouisianaLouisiana | — | $417.84 |
| Metropolitan Boston, MAMassachusetts | — | $493.19 |
| Rest of MassachusettsMassachusetts | — | $453.15 |
| Baltimore area, MDMaryland | — | $473.73 |
| Rest of MarylandMaryland | — | $447.13 |
| Rest of MaineMaine | — | $413.58 |
| Southern Maine, MEMaine | — | $430.08 |
| Detroit, MIMichigan | — | $462.57 |
| Rest of MichiganMichigan | — | $430.45 |
| MinnesotaMinnesota | — | $426.54 |
| Metropolitan Kansas City, MOMissouri | — | $430.84 |
| Metropolitan St. Louis, MOMissouri | — | $434.71 |
| Rest of MissouriMissouri | — | $413.19 |
| MississippiMississippi | — | $404.40 |
| MontanaMontana | — | $445.50 |
| North CarolinaNorth Carolina | — | $417.16 |
| North DakotaNorth Dakota | — | $423.94 |
| NebraskaNebraska | — | $405.38 |
| New HampshireNew Hampshire | — | $450.36 |
| Northern New JerseyNew Jersey | — | $495.92 |
| Rest of New JerseyNew Jersey | — | $477.31 |
| New MexicoNew Mexico | — | $433.98 |
| NevadaNevada | — | $439.72 |
| NYC suburbs and Long Island, NYNew York | — | $531.43 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $483.02 |
| Queens, NYNew York | — | $514.73 |
| Rest of New YorkNew York | — | $423.37 |
| OhioOhio | — | $426.04 |
| OklahomaOklahoma | — | $413.08 |
| Portland, OROregon | — | $464.43 |
| Rest of OregonOregon | — | $433.84 |
| Metropolitan Philadelphia, PAPennsylvania | — | $465.20 |
| Rest of PennsylvaniaPennsylvania | — | $424.89 |
| Puerto RicoPuerto Rico | — | $447.53 |
| Rhode IslandRhode Island | — | $452.60 |
| South CarolinaSouth Carolina | — | $422.79 |
| South DakotaSouth Dakota | — | $421.39 |
| TennesseeTennessee | — | $407.98 |
| Austin, TXTexas | — | $454.99 |
| Beaumont, TXTexas | — | $422.48 |
| Brazoria, TXTexas | — | $436.96 |
| Dallas, TXTexas | — | $441.12 |
| Fort Worth, TXTexas | — | $439.31 |
| Galveston, TXTexas | — | $439.16 |
| Houston, TXTexas | — | $459.11 |
| Rest of TexasTexas | — | $430.42 |
| UtahUtah | — | $428.19 |
| VirginiaVirginia | — | $430.99 |
| Virgin Islands, VIUnited States Virgin Islands | — | $447.53 |
| VermontVermont | — | $425.31 |
| Rest of WashingtonWashington | — | $451.30 |
| King County, WAWashington | — | $499.68 |
| WisconsinWisconsin | — | $410.81 |
| West VirginiaWest Virginia | — | $431.42 |
| WyomingWyoming | — | $436.10 |
46948 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 46948
RVUs × geographic indexes × conversion factor
Work5.43
5.43 RVUs× 1.000 GPCI
Practice expense6.82
6.82 RVUs× 1.000 GPCI
Malpractice1.09
1.09 RVUs× 1.000 GPCI
Adjusted RVUs
13.3400
Conversion factor
$33.4009
Medicare rate
$445.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Colorado inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,642
- Code
- 46948
- Physician work
- 5.43
- Practice expense
- 6.82
- Malpractice
- 1.09
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.43 | × 1.012 | 5.4952 |
| Practice expense | 6.82 | × 1.064 | 7.2565 |
| Malpractice | 1.09 | × 0.781 | 0.8513 |
| Total RVUs | 13.6029 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$454.35
Facility: (5.43 × 1.012 + 6.82 × 1.064 + 1.09 × 0.781) × $33.4009 = $454.35
Payment rules and modifiers for 46948
46948 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46948
Hemorrhoid surgery, doppler-guided, two or more columns
| 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 · 46948
Hemorrhoid surgery, doppler-guided, two or more columns
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
46948 without 51 · national facility
$445.57
Hemorrhoid surgery, doppler-guided, two or more columns
46948-51 · Second procedure: 50%
$222.79
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%).
How 46948 has changed in Colorado
46948 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
January 1, 2020
RVU20A
No ratechanged 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.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $454.35 | RVU26D |
| 2026-07-01 | Not available in this setting | $454.35 | RVU26C |
| 2026-04-01 | Not available in this setting | $454.35 | RVU26B |
| 2026-01-01 | Not available in this setting | $454.35 | RVU26A |
| 2025-10-01 | Not available in this setting | $442.75 | RVU25D |
| 2025-07-01 | Not available in this setting | $442.75 | RVU25C |
| 2025-04-01 | Not available in this setting | $442.75 | RVU25B |
| 2025-01-01 | Not available in this setting | $442.75 | RVU25A |
| 2024-10-01 | Not available in this setting | $453.07 | RVU24D |
| 2024-07-01 | Not available in this setting | $453.07 | RVU24C |
| 2024-04-01 | Not available in this setting | $453.07 | RVU24B |
| 2024-03-09 | Not available in this setting | $453.07 | RVU24AR |
| 2024-01-01 | Not available in this setting | $445.68 | RVU24A |
| 2023-10-01 | Not available in this setting | $457.62 | RVU23D |
| 2023-07-01 | Not available in this setting | $457.62 | RVU23C |
| 2023-04-01 | Not available in this setting | $457.62 | RVU23B |
| 2023-01-01 | Not available in this setting | $457.62 | RVU23A |
| 2022-10-01 | Not available in this setting | $464.81 | RVU22D |
| 2022-07-01 | Not available in this setting | $464.81 | RVU22C |
| 2022-04-01 | Not available in this setting | $464.81 | RVU22B |
| 2022-01-01 | Not available in this setting | $464.81 | RVU22A |
| 2021-10-01 | Not available in this setting | $464.38 | RVU21D |
| 2021-07-01 | Not available in this setting | $464.38 | RVU21C |
| 2021-04-01 | Not available in this setting | $464.38 | RVU21B |
| 2021-01-01 | Not available in this setting | $464.38 | RVU21A |
| 2020-10-01 | Not available in this setting | $462.17 | RVU20D |
| 2020-07-01 | Not available in this setting | $462.17 | RVU20C |
| 2020-04-01 | Not available in this setting | $462.17 | RVU20B |
| 2020-01-01 | Not available in this setting | $462.17 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Colorado rate applies
Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.
- Acres Green
- Aetna Estates
- Aguilar
- Air Force Academy
- Akron
- Alamosa
- Alamosa East
- Allenspark
46948 billing questions
How does this differ from code 46946?
Code 46948 describes transanal dearterialization using Doppler guidance. Code 46946 is for internal hemorrhoid ligation by a different technique.
Is Doppler guidance separately reportable?
No. The guidance is included in this service.
How many units should be reported?
The code covers treatment of two or more internal hemorrhoid columns or groups. Do not report a separate unit for each column.
Should modifier 50 be appended?
No. The service is defined by the number of hemorrhoid columns or groups treated, not by bilateral anatomy.
What should the operative note document?
Document the transanal Doppler-guided technique and identify treatment of at least two internal hemorrhoid columns or groups.
Can an assistant or co-surgeon be billed to Medicare?
Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing 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
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