Billing code 46930: Hemorrhoid treatmentMedicare rate & RVUs

Medicare pays $247.83 for 46930 nationally in the office and $157.65 in a hospital or facility. Local office rates run $217.76–$333.31.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 46930 covers

A clinician applies thermal energy to internal hemorrhoidal tissue, commonly using an infrared coagulation device through an anoscope. Colorectal surgeons, general surgeons, and gastroenterologists may perform the treatment in an office or outpatient setting for symptomatic internal hemorrhoids selected for this approach.

Report 46930 for thermal destruction, including infrared coagulation; rubber-band ligation and operative hemorrhoid procedures are different services. Documentation should identify the internal hemorrhoids and the thermal treatment performed. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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 46930 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

46930 rates by state

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

How the 46930 rate is calculated

Each of 46930’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 46930

46930 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

46930 compared with similar codes

How to choose

46945Hemorrhoid ligation

46945 describes ligation of one internal hemorrhoid. Choose 46930 when thermal energy is used instead of ligation.

46946Hemorrhoid ligation

46946 describes ligation of two or more internal hemorrhoids. Thermal destruction is reported with 46930, regardless of whether one or multiple hemorrhoids are treated.

46947Hemorrhoidopexy

46947 represents stapled hemorrhoidopexy, an operative procedure; 46930 represents thermal destruction of internal hemorrhoidal tissue.

46900Anal lesion destruction

46900 is for destruction of anal lesion(s), not thermal treatment of internal hemorrhoids. Identify the treated condition and method.

Codes related to 46930

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