No office rate
Both include fistulectomy with internal and external hemorrhoid removal. Choose 46258 for one group and 46262 for two or more.
On this page
CMS RVU26D · Effective 2026-10-01
46262 in Madera
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$585.41
Base rate per service
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.
Anorectal surgery
About 46262: Multi-group hemorrhoidectomy with fistulectomy
Reports excision of internal and external hemorrhoids in two or more groups together with fistulectomy, with fissurectomy included when performed.
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.
CMS billing rules for 46262
- 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 RVU7.71 · 44%
- Practice expense (office) RVU7.83 · 44%
- Malpractice RVU2.06 · 12%
67
Medicare services in 2024 · #5173 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.
46262 compared with similar codes
Office rates for Madera, from the same CMS release.
No office rate
Both cover removal from two or more hemorrhoid groups. Choose 46262 when fistulectomy is also performed; 46260 describes the hemorrhoidectomy without it.
No office rate
Both cover two or more hemorrhoid groups, but 46261 includes fissurectomy while 46262 includes fistulectomy.
The same code, a different location
How does Madera compare?
46262 across payment areas
Same release and payment basis · bars start at $0
Madera · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Modesto
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Napa
California · 46262
Office
Unavailable
Facility
$653.39
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 46262
Office
Unavailable
Facility
$616.72
No comparable office rate is available.
Redding
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Rest Of California
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 46262
Office
Unavailable
Facility
$607.48
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 46262
Office
Unavailable
Facility
$607.83
No comparable office rate is available.
Salinas
California · 46262
Office
Unavailable
Facility
$605.50
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 46262
Office
Unavailable
Facility
$615.33
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 46262
Office
Unavailable
Facility
$682.32
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 46262
Office
Unavailable
Facility
$679.98
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 46262
Office
Unavailable
Facility
$699.85
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 46262
Office
Unavailable
Facility
$690.29
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 46262
Office
Unavailable
Facility
$596.66
No comparable office rate is available.
Santa Cruz-Watsonville
California · 46262
Office
Unavailable
Facility
$617.57
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 46262
Office
Unavailable
Facility
$606.55
No comparable office rate is available.
Santa Rosa-Petaluma
California · 46262
Office
Unavailable
Facility
$623.28
No comparable office rate is available.
Stockton
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Vallejo
California · 46262
Office
Unavailable
Facility
$650.02
No comparable office rate is available.
Visalia
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Yuba City
California · 46262
Office
Unavailable
Facility
$585.41
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 46262
Office
Unavailable
Facility
$656.09
No comparable office rate is available.
Miami
Florida · 46262
Office
Unavailable
Facility
$703.78
No comparable office rate is available.
Chicago
Illinois · 46262
Office
Unavailable
Facility
$680.07
No comparable office rate is available.
Manhattan
New York · 46262
Office
Unavailable
Facility
$687.03
No comparable office rate is available.
Alaska*
Alaska · 46262
Office
Unavailable
Facility
$702.72
No comparable office rate is available.
Alabama
Alabama · 46262
Office
Unavailable
Facility
$525.30
No comparable office rate is available.
Arkansas
Arkansas · 46262
Office
Unavailable
Facility
$517.61
No comparable office rate is available.
Arizona
Arizona · 46262
Office
Unavailable
Facility
$569.84
No comparable office rate is available.
Colorado
Colorado · 46262
Office
Unavailable
Facility
$592.62
No comparable office rate is available.
Connecticut
Connecticut · 46262
Office
Unavailable
Facility
$627.59
No comparable office rate is available.
Delaware
Delaware · 46262
Office
Unavailable
Facility
$579.06
No comparable office rate is available.
Fort Lauderdale
Florida · 46262
Office
Unavailable
Facility
$646.85
No comparable office rate is available.
Rest Of Florida
Florida · 46262
Office
Unavailable
Facility
$610.96
No comparable office rate is available.
Atlanta
Georgia · 46262
Office
Unavailable
Facility
$606.64
No comparable office rate is available.
Rest Of Georgia
Georgia · 46262
Office
Unavailable
Facility
$572.82
No comparable office rate is available.
Hawaii, Guam
Hawaii · 46262
Office
Unavailable
Facility
$594.72
No comparable office rate is available.
Iowa
Iowa · 46262
Office
Unavailable
Facility
$524.14
No comparable office rate is available.
Idaho
Idaho · 46262
Office
Unavailable
Facility
$530.67
No comparable office rate is available.
East St. Louis
Illinois · 46262
Office
Unavailable
Facility
$636.70
No comparable office rate is available.
Rest Of Illinois
Illinois · 46262
Office
Unavailable
Facility
$603.84
No comparable office rate is available.
Suburban Chicago
Illinois · 46262
Office
Unavailable
Facility
$649.84
No comparable office rate is available.
Indiana
Indiana · 46262
Office
Unavailable
Facility
$533.40
No comparable office rate is available.
Kansas
Kansas · 46262
Office
Unavailable
Facility
$528.62
No comparable office rate is available.
Kentucky
Kentucky · 46262
Office
Unavailable
Facility
$552.98
No comparable office rate is available.
New Orleans
Louisiana · 46262
Office
Unavailable
Facility
$581.78
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 46262
Office
Unavailable
Facility
$554.89
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 46262
Office
Unavailable
Facility
$641.58
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 46262
Office
Unavailable
Facility
$591.87
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 46262
Office
Unavailable
Facility
$627.37
No comparable office rate is available.
Rest Of Maryland
Maryland · 46262
Office
Unavailable
Facility
$587.93
No comparable office rate is available.
Rest Of Maine
Maine · 46262
Office
Unavailable
Facility
$540.92
No comparable office rate is available.
Southern Maine
Maine · 46262
Office
Unavailable
Facility
$560.11
No comparable office rate is available.
Detroit
Michigan · 46262
Office
Unavailable
Facility
$625.90
No comparable office rate is available.
Rest Of Michigan
Michigan · 46262
Office
Unavailable
Facility
$573.98
No comparable office rate is available.
Minnesota
Minnesota · 46262
Office
Unavailable
Facility
$547.00
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 46262
Office
Unavailable
Facility
$570.32
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 46262
Office
Unavailable
Facility
$575.44
No comparable office rate is available.
Rest Of Missouri
Missouri · 46262
Office
Unavailable
Facility
$549.98
No comparable office rate is available.
Mississippi
Mississippi · 46262
Office
Unavailable
Facility
$533.54
No comparable office rate is available.
Montana**
Montana · 46262
Office
Unavailable
Facility
$587.72
No comparable office rate is available.
North Carolina
North Carolina · 46262
Office
Unavailable
Facility
$545.49
No comparable office rate is available.
North Dakota**
North Dakota · 46262
Office
Unavailable
Facility
$546.99
No comparable office rate is available.
Nebraska
Nebraska · 46262
Office
Unavailable
Facility
$524.92
No comparable office rate is available.
New Hampshire
New Hampshire · 46262
Office
Unavailable
Facility
$589.98
No comparable office rate is available.
Northern Nj
New Jersey · 46262
Office
Unavailable
Facility
$650.60
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 46262
Office
Unavailable
Facility
$628.89
No comparable office rate is available.
New Mexico
New Mexico · 46262
Office
Unavailable
Facility
$579.98
No comparable office rate is available.
Nevada**
Nevada · 46262
Office
Unavailable
Facility
$576.63
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 46262
Office
Unavailable
Facility
$712.73
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 46262
Office
Unavailable
Facility
$638.74
No comparable office rate is available.
Queens
New York · 46262
Office
Unavailable
Facility
$682.35
No comparable office rate is available.
Rest Of New York
New York · 46262
Office
Unavailable
Facility
$554.34
No comparable office rate is available.
Ohio
Ohio · 46262
Office
Unavailable
Facility
$565.65
No comparable office rate is available.
Oklahoma
Oklahoma · 46262
Office
Unavailable
Facility
$544.53
No comparable office rate is available.
Portland
Oregon · 46262
Office
Unavailable
Facility
$603.39
No comparable office rate is available.
Rest Of Oregon
Oregon · 46262
Office
Unavailable
Facility
$566.37
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 46262
Office
Unavailable
Facility
$616.49
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 46262
Office
Unavailable
Facility
$562.63
No comparable office rate is available.
Puerto Rico
Puerto Rico · 46262
Office
Unavailable
Facility
$589.70
No comparable office rate is available.
Rhode Island
Rhode Island · 46262
Office
Unavailable
Facility
$593.95
No comparable office rate is available.
South Carolina
South Carolina · 46262
Office
Unavailable
Facility
$557.66
No comparable office rate is available.
South Dakota**
South Dakota · 46262
Office
Unavailable
Facility
$542.17
No comparable office rate is available.
Tennessee
Tennessee · 46262
Office
Unavailable
Facility
$532.20
No comparable office rate is available.
Austin
Texas · 46262
Office
Unavailable
Facility
$595.70
No comparable office rate is available.
Beaumont
Texas · 46262
Office
Unavailable
Facility
$559.43
No comparable office rate is available.
Brazoria
Texas · 46262
Office
Unavailable
Facility
$572.42
No comparable office rate is available.
Dallas
Texas · 46262
Office
Unavailable
Facility
$579.36
No comparable office rate is available.
Fort Worth
Texas · 46262
Office
Unavailable
Facility
$577.64
No comparable office rate is available.
Galveston
Texas · 46262
Office
Unavailable
Facility
$576.25
No comparable office rate is available.
Houston
Texas · 46262
Office
Unavailable
Facility
$613.96
No comparable office rate is available.
Rest Of Texas
Texas · 46262
Office
Unavailable
Facility
$567.84
No comparable office rate is available.
Utah
Utah · 46262
Office
Unavailable
Facility
$565.15
No comparable office rate is available.
Virginia
Virginia · 46262
Office
Unavailable
Facility
$563.18
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 46262
Office
Unavailable
Facility
$589.70
No comparable office rate is available.
Vermont
Vermont · 46262
Office
Unavailable
Facility
$551.25
No comparable office rate is available.
Rest Of Washington
Washington · 46262
Office
Unavailable
Facility
$588.62
No comparable office rate is available.
Seattle (King Cnty)
Washington · 46262
Office
Unavailable
Facility
$647.51
No comparable office rate is available.
Wisconsin
Wisconsin · 46262
Office
Unavailable
Facility
$529.26
No comparable office rate is available.
West Virginia
West Virginia · 46262
Office
Unavailable
Facility
$583.25
No comparable office rate is available.
Wyoming**
Wyoming · 46262
Office
Unavailable
Facility
$569.97
No comparable office rate is available.
See how rates vary across the country
46262 · 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.
View all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Madera is a Medicare payment area. Our Census mapping connects it to 17 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 46262 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$643.95
$585.41 × 110% = $643.95
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 46262 in Madera.
PPRRVU2026_Oct_nonQPP.csv
5,589
- Code
- 46262
- Physician work
- 7.71
- Practice expense
- 7.83
- Malpractice
- 2.06
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.71 | × 1.017 | 7.8411 |
| Practice expense | 7.83 | × 1.096 | 8.5817 |
| Malpractice | 2.06 | × 0.536 | 1.1042 |
| Total RVUs | 17.5269 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Madera$585.41
Open 46262 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.71 | 1.017 |
| Practice expense | 7.83 | 1.096 |
| Malpractice | 2.06 | 0.536 |
(7.71 × 1.017 + 7.83 × 1.096 + 2.06 × 0.536) × $33.4009 = $585.41
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
46262 · 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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $585.41 | RVU26D |
| 2026-07-01 | Not available in this setting | $585.41 | RVU26C |
| 2026-04-01 | Not available in this setting | $585.41 | RVU26B |
| 2026-01-01 | Not available in this setting | $585.41 | RVU26A |
| 2025-10-01 | Not available in this setting | $578.52 | RVU25D |
| 2025-07-01 | Not available in this setting | $578.52 | RVU25C |
| 2025-04-01 | Not available in this setting | $578.52 | RVU25B |
| 2025-01-01 | Not available in this setting | $578.52 | RVU25A |
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 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.
5,58646258,,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
5,58846261,,Remove in/ex hem grps & fiss,A,,7.57,6.42,NA,6.42,,1.44,15.43,15.43,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58946262,,Remove in/ex hem grps w/fist,A,,7.71,7.83,NA,7.83,,2.06,17.60,17.60,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59046270,,Remove anal fist subq,A,,4.80,12.17,,6.43,,0.99,17.96,12.22,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59146275,,Remove anal fist inter,A,,5.28,12.62,,6.47,,0.98,18.88,12.73,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59246280,,Remove anal fist complex,A,,6.23,7.06,NA,7.06,,1.16,14.45,14.45,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508