No office rate
Use 46255 when one mixed internal-external group is excised; use 46260 when multiple such groups are removed.
On this page
CMS RVU26D · Effective 2026-10-01
46255 Hemorrhoidectomy Medicare reimbursement rates
Reports excision of one hemorrhoid group involving both internal and external tissue, typically when a surgeon removes the combined disease surgically. Compare 46255 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 46255?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$511.28–$756.36
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $245.08 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 46255 pays more and less
109 payment localities
$511.28 to $756.36
Colorectal surgery
About 46255: Single-group mixed hemorrhoidectomy
Reports excision of one hemorrhoid group involving both internal and external tissue, typically when a surgeon removes the combined disease surgically.
A surgeon excises one group of hemorrhoidal tissue that has both internal and external components. The procedure is commonly performed by a colorectal or general surgeon in an operating room or other surgical setting. The defining distinction is one combined group, rather than external-only disease or multiple groups of mixed internal and external hemorrhoids.
The operative report should support removal of both components and identify the extent as a single group or column. This major surgery has a 90-day global period, including 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 46255
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.84 · 28%
- Practice expense (office) RVU11.64 · 67%
- Malpractice RVU0.91 · 5%
3.8K
Medicare services in 2024 · #2025 by national volume
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.
46255 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$470.92–$702.67
46250 is for excision of multiple external hemorrhoid groups. 46255 requires a single group with both internal and external tissue.
No office rate
Both involve one mixed hemorrhoid group, but 46257 also includes fissurectomy.
$286.44–$433.20
46221 reports hemorrhoid ligation rather than excision of a mixed internal-external group.
See how rates vary across the country
46255 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$511.28
$681.59
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $673.30 | 1 |
| AL | $519.05 | 1 |
| AR | $511.28 | 1 |
| AZ | $564.41 | 1 |
| CA | $606.81–$756.36 | 29 |
| CO | $601.01 | 1 |
| CT | $620.39 | 1 |
| DC | $662.21 | 1 |
| DE | $573.91 | 1 |
| FL | $579.02–$643.26 | 3 |
| GA | $544.69–$593.66 | 2 |
| GU | $621.31 | 1 |
| HI | $621.31 | 1 |
| IA | $529.47 | 1 |
| ID | $533.72 | 1 |
| IL | $564.13–$623.28 | 4 |
| IN | $536.84 | 1 |
| KS | $528.44 | 1 |
| KY | $535.10 | 1 |
| LA | $534.85–$562.04 | 2 |
| MA | $597.86–$659.55 | 2 |
| MD | $584.63–$662.21 | 3 |
| ME | $538.25–$566.13 | 2 |
| MI | $550.94–$588.08 | 2 |
| MN | $570.72 | 1 |
| MO | $526.40–$562.24 | 3 |
| MS | $518.87 | 1 |
| MT | $580.78 | 1 |
| NC | $543.82 | 1 |
| ND | $562.79 | 1 |
| NE | $532.00 | 1 |
| NH | $592.98 | 1 |
| NJ | $626.02–$655.30 | 2 |
| NM | $554.68 | 1 |
| NV | $576.15 | 1 |
| NY | $552.38–$690.72 | 5 |
| OH | $547.26 | 1 |
| OK | $532.46 | 1 |
| OR | $570.26–$618.80 | 2 |
| PA | $547.29–$605.56 | 2 |
| PR | $584.66 | 1 |
| RI | $593.46 | 1 |
| SC | $546.73 | 1 |
| SD | $560.66 | 1 |
| TN | $531.39 | 1 |
| TX | $543.69–$600.25 | 8 |
| UT | $554.41 | 1 |
| VA | $565.30–$662.21 | 2 |
| VI | $584.66 | 1 |
| VT | $561.94 | 1 |
| WA | $596.28–$671.62 | 2 |
| WI | $543.48 | 1 |
| WV | $543.01 | 1 |
| WY | $572.94 | 1 |
Compare 46255 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $519.05 | Facility $317.69 |
| Alaska* | Office $673.30 | Facility $428.20 |
| Arizona | Office $564.41 | Facility $341.41 |
| Arkansas | Office $511.28 | Facility $313.60 |
| Atlanta | Office $593.66 | Facility $359.84 |
| Austin | Office $600.25 | Facility $356.77 |
| Bakersfield | Office $609.35 | Facility $357.13 |
| Baltimore/Surr. Cntys | Office $619.01 | Facility $372.08 |
| Beaumont | Office $543.69 | Facility $334.27 |
| Brazoria | Office $571.95 | Facility $343.89 |
| Chicago | Office $623.28 | Facility $392.00 |
| Chico | Office $606.81 | Facility $354.59 |
| Colorado | Office $601.01 | Facility $356.15 |
| Connecticut | Office $620.39 | Facility $372.54 |
| Dallas | Office $576.43 | Facility $347.21 |
| Dc + Md/Va Suburbs | Office $662.21 | Facility $391.11 |
| Delaware | Office $573.91 | Facility $346.54 |
| Detroit | Office $588.08 | Facility $366.01 |
| East St. Louis | Office $580.56 | Facility $368.84 |
| El Centro | Office $606.96 | Facility $354.74 |
| Fort Lauderdale | Office $610.45 | Facility $377.33 |
| Fort Worth | Office $572.93 | Facility $346.02 |
| Fresno | Office $606.81 | Facility $354.59 |
| Galveston | Office $574.19 | Facility $345.66 |
| Hanford-Corcoran | Office $606.81 | Facility $354.59 |
| Hawaii, Guam | Office $621.31 | Facility $359.65 |
| Houston | Office $590.84 | Facility $362.32 |
| Idaho | Office $533.72 | Facility $322.00 |
| Indiana | Office $536.84 | Facility $323.50 |
| Iowa | Office $529.47 | Facility $318.90 |
| Kansas | Office $528.44 | Facility $320.40 |
| Kentucky | Office $535.10 | Facility $330.52 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $648.40 | Facility $376.16 |
| Madera | Office $606.81 | Facility $354.59 |
| Manhattan | Office $671.98 | Facility $404.57 |
| Merced | Office $606.81 | Facility $354.59 |
| Metropolitan Boston | Office $659.55 | Facility $384.77 |
| Metropolitan Kansas City | Office $556.43 | Facility $340.33 |
| Metropolitan Philadelphia | Office $605.56 | Facility $365.99 |
| Metropolitan St. Louis | Office $562.24 | Facility $343.15 |
| Miami | Office $643.26 | Facility $403.69 |
| Minnesota | Office $570.72 | Facility $333.91 |
| Mississippi | Office $518.87 | Facility $320.72 |
| Modesto | Office $606.81 | Facility $354.59 |
| Montana** | Office $580.78 | Facility $350.65 |
| Napa | Office $699.71 | Facility $396.39 |
| Nebraska | Office $532.00 | Facility $319.59 |
| Nevada** | Office $576.15 | Facility $345.79 |
| New Hampshire | Office $592.98 | Facility $353.41 |
| New Mexico | Office $554.68 | Facility $343.65 |
| New Orleans | Office $562.04 | Facility $345.48 |
| North Carolina | Office $543.82 | Facility $329.11 |
| North Dakota** | Office $562.79 | Facility $332.65 |
| Northern Nj | Office $655.30 | Facility $388.35 |
| Nyc Suburbs/Long Island | Office $690.72 | Facility $417.09 |
| Ohio | Office $547.26 | Facility $337.15 |
| Oklahoma | Office $532.46 | Facility $326.96 |
| Oxnard-Thousand Oaks-Ventura | Office $644.67 | Facility $372.65 |
| Portland | Office $618.80 | Facility $363.13 |
| Poughkpsie/N Nyc Suburbs | Office $631.43 | Facility $379.44 |
| Puerto Rico | Office $584.66 | Facility $352.00 |
| Queens | Office $675.38 | Facility $403.37 |
| Redding | Office $606.81 | Facility $354.59 |
| Rest Of California | Office $606.81 | Facility $354.59 |
| Rest Of Florida | Office $579.02 | Facility $359.02 |
| Rest Of Georgia | Office $544.69 | Facility $339.41 |
| Rest Of Illinois | Office $564.13 | Facility $354.02 |
| Rest Of Louisiana | Office $534.85 | Facility $331.19 |
| Rest Of Maine | Office $538.25 | Facility $326.53 |
| Rest Of Maryland | Office $584.63 | Facility $351.74 |
| Rest Of Massachusetts | Office $597.86 | Facility $355.53 |
| Rest Of Michigan | Office $550.94 | Facility $340.83 |
| Rest Of Missouri | Office $526.40 | Facility $328.02 |
| Rest Of New Jersey | Office $626.02 | Facility $374.72 |
| Rest Of New York | Office $552.38 | Facility $333.75 |
| Rest Of Oregon | Office $570.26 | Facility $341.05 |
| Rest Of Pennsylvania | Office $547.29 | Facility $336.03 |
| Rest Of Texas | Office $558.07 | Facility $339.67 |
| Rest Of Washington | Office $596.28 | Facility $353.96 |
| Rhode Island | Office $593.46 | Facility $355.73 |
| Riverside-San Bernardino-Ontario | Office $616.61 | Facility $364.38 |
| Sacramento-Roseville-Folsom | Office $635.93 | Facility $368.29 |
| Salinas | Office $633.57 | Facility $366.84 |
| San Diego-Chula Vista-Carlsbad | Office $647.97 | Facility $372.73 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $739.16 | Facility $414.67 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $738.12 | Facility $413.64 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $756.36 | Facility $424.51 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $752.14 | Facility $420.29 |
| San Luis Obispo-Paso Robles | Office $623.53 | Facility $361.41 |
| Santa Cruz-Watsonville | Office $653.72 | Facility $374.11 |
| Santa Maria-Santa Barbara | Office $635.80 | Facility $367.47 |
| Santa Rosa-Petaluma | Office $660.23 | Facility $377.63 |
| Seattle (King Cnty) | Office $671.62 | Facility $389.24 |
| South Carolina | Office $546.73 | Facility $334.09 |
| South Dakota** | Office $560.66 | Facility $330.53 |
| Southern Maine | Office $566.13 | Facility $338.07 |
| Stockton | Office $606.81 | Facility $354.59 |
| Suburban Chicago | Office $615.94 | Facility $379.59 |
| Tennessee | Office $531.39 | Facility $322.20 |
| Utah | Office $554.41 | Facility $338.09 |
| Vallejo | Office $698.22 | Facility $394.90 |
| Vermont | Office $561.94 | Facility $334.11 |
| Virgin Islands | Office $584.66 | Facility $352.00 |
| Virginia | Office $565.30 | Facility $339.08 |
| Visalia | Office $606.81 | Facility $354.59 |
| West Virginia | Office $543.01 | Facility $343.03 |
| Wisconsin | Office $543.48 | Facility $323.01 |
| Wyoming** | Office $572.94 | Facility $342.81 |
| Yuba City | Office $606.81 | Facility $354.59 |
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46255 billing questions
How does this differ from 46260?
46255 is for one group containing internal and external hemorrhoidal tissue. 46260 is for excision of multiple groups involving both.
Can 46255 be used for external hemorrhoids only?
No. This code represents excision of a group with both internal and external components; 46250 describes excision of multiple external groups.
Is modifier 50 appropriate?
No. CMS identifies bilateral adjustment as inapplicable because the descriptor or anatomy makes modifier 50 inappropriate.
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.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,58146221,,Ligation of hemorrhoid(s),A,,2.30,7.09,,3.24,,0.36,9.75,5.90,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58246230,,Removal of anal tags,A,,2.55,7.22,,1.95,,0.48,10.25,4.98,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58346250,,Remove ext hem groups 2+,A,,4.14,11.09,,4.56,,0.84,16.07,9.54,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58446255,,Remove int/ext hem 1 group,A,,4.84,11.64,,4.75,,0.91,17.39,10.50,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58546257,,Remove in/ex hem grp & fiss,A,,5.62,6.02,NA,6.02,,0.81,12.45,12.45,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58646258,,Remove in/ex hem grp w/fistu,A,,6.25,6.48,NA,6.48,,1.67,14.40,14.40,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58746260,,Remove in/ex hem groups 2+,A,,6.56,6.46,NA,6.46,,1.34,14.36,14.36,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00