FeeBase
Log inGet started
Menu

Billing code 46262: HemorrhoidectomyMedicare rate & RVUs

Reports excision of internal and external hemorrhoids in two or more groups together with fistulectomy, with fissurectomy included when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities67 Medicare services in 2024

Medicare pays $587.86 for 46262 nationally in a facility.

Medicare rate · 46262

Hemorrhoidectomy

Swap in your local Medicare rate.

Work RVUs
7.71
Total RVUs
17.60
Global days
090

National rate · 2026

$587.86

Facility setting, before claim adjustments.

See every locality for 46262 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 46262 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 46262 covers

A surgeon removes internal and external hemorrhoidal tissue from at least two columns or groups and excises an associated anal fistula. Fissurectomy may also be performed as part of the service. This operation is typically performed by a colorectal or general surgeon in an operating room, commonly in a facility setting.

Select this code when the operative report supports removal of hemorrhoids from two or more groups and fistula excision during the same operation. The note should identify the treated hemorrhoidal groups and describe the fistula work; a hemorrhoid procedure without fistulectomy belongs to a different code. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period. 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 multiple procedure reduction. 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 46262 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

46262 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$525.30
Alaska*Unavailable$702.72
ArizonaUnavailable$569.84
ArkansasUnavailable$517.61
AtlantaUnavailable$606.64
AustinUnavailable$595.70
BakersfieldUnavailable$590.95
Baltimore/Surr. CntysUnavailable$627.37
BeaumontUnavailable$559.43
BrazoriaUnavailable$572.42

46262 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
46262 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 46262 rate is calculated

Each of 46262’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 · 46262

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.71Practice expense 7.83Malpractice 2.06

17.6000 adjusted RVUs×$33.4009 conversion factor=$587.86

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 46262

46262 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46262

Hemorrhoidectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46262

Hemorrhoidectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46262 without 51 · national facility

$587.86

Hemorrhoidectomy

46262-51 · Second procedure: 50%

$293.93

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%).

When to use modifier 51

46262 compared with similar codes

Compare codes

46262 vs 46258 vs 46260 vs 46261: national Medicare rates

Swap in your local Medicare rate.

  • 46262
    Hemorrhoidectomy · 7.71 wRVU
    —
  • 46258
    Hemorrhoidectomy · 6.25 wRVU
    —
  • 46260
    Hemorrhoidectomy · 6.56 wRVU
    —
  • 46261
    Hemorrhoidectomy · 7.57 wRVU
    —

How to choose

46258Hemorrhoidectomy
Both include fistulectomy with internal and external hemorrhoid removal. Choose 46258 for one group and 46262 for two or more.
46260Hemorrhoidectomy
Both cover removal from two or more hemorrhoid groups. Choose 46262 when fistulectomy is also performed; 46260 describes the hemorrhoidectomy without it.
46261Hemorrhoidectomy
Both cover two or more hemorrhoid groups, but 46261 includes fissurectomy while 46262 includes fistulectomy.

Codes related to 46262

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

Codes related to 46262
CodeHow it relatesNational office range
Same family
46258HemorrhoidectomyFistulectomy with hemorrhoid removal from a single group rather than two or more.No office rate
46260HemorrhoidectomyTwo or more hemorrhoid groups are removed without the fistulectomy included in 46262.No office rate
46261HemorrhoidectomyTwo or more groups with fissurectomy, rather than the fistulectomy service in 46262.No office rate

46262 billing questions

How does this differ from 46258?

46262 is for hemorrhoidal tissue removed from two or more groups with fistulectomy. Code 46258 is the corresponding fistulectomy service for a single group.

When is 46260 a better choice?

Use 46260 for removal of internal and external hemorrhoids from two or more groups when the operation does not include fistulectomy. Code 46262 includes the fistula excision.

Can fissurectomy be part of this service?

Yes. Fissurectomy may be performed as part of the operation described by 46262; the code also includes fistulectomy.

Should modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What postoperative care is included?

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 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
RVUs for 46262PPRRVU2026_Oct_nonQPP.csv, line 5,589 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 46262 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 46262 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →