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CMS RVU26D · Effective 2026-10-01

46250 in Merced

Office / nonfacility

$561.64

Base rate per service

Facility setting

$322.60

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 46250: External hemorrhoidectomy, multiple groups

Reports excisional surgery for external hemorrhoids involving two or more groups, rather than a single group or internal-and-external disease.

This code describes operative excision of external hemorrhoids in two or more groups. It is typically performed by a colorectal or general surgeon for symptomatic external hemorrhoidal disease requiring removal, often in a surgical facility. The operative report should identify the external disease treated and document excision involving multiple groups; a procedure limited to anal tags or to hemorrhoid ligation is a different service.

Report the code once for the qualifying excision, not once per group. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 46250

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 RVU4.14 · 26%
  • Practice expense (office) RVU11.09 · 69%
  • Malpractice RVU0.84 · 5%

868

Medicare services in 2024 · #3069 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.

46250 compared with similar codes

Office rates for Merced, from the same CMS release.

46255

Hemorrhoidectomy

One internal and external group

$606.81

46255 is for combined internal and external hemorrhoidectomy involving one group. This code is for external hemorrhoids involving two or more groups.

46260

Hemorrhoidectomy

Internal and external, 2+ groups

No office rate

46260 includes excision of internal and external hemorrhoids in two or more groups; this code addresses external hemorrhoids only.

46221

Hemorrhoid ligation

Rubber-band technique

$344.12

46221 reports hemorrhoid ligation, not excisional removal of multiple external hemorrhoid groups.

46230

Anal tag excision

Multiple tags

$359.52

46230 is for excision of multiple anal tags. Use this code when the operative service is hemorrhoidectomy involving multiple external groups.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 46250 is $563.97—$2.33 higher than the $561.64 rate in Merced. Both use the same code, release and participation basis.

46250 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $561.64

  2. Bakersfield

    $563.97

    $2.33 higher than Merced

  3. Chico

    $561.64

    The same base rate than Merced

  4. El Centro

    $561.79

    $0.15 higher than Merced

  5. Fresno

    $561.64

    The same base rate than Merced

  6. Hanford-Corcoran

    $561.64

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $600.78

    $39.14 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 46250 ranges from $470.92 in Arkansas to $702.67 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Madera

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Modesto

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Napa

    California · 46250

    Office

    $649.45

    Facility

    $361.99

    $87.81 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 46250

    Office

    $597.46

    Facility

    $339.66

    $35.82 higher than Merced for the office setting.

  • Redding

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 46250

    Office

    $570.68

    Facility

    $331.63

    $9.04 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 46250

    Office

    $589.09

    Facility

    $335.43

    $27.45 higher than Merced for the office setting.

  • Salinas

    California · 46250

    Office

    $586.92

    Facility

    $334.13

    $25.28 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 46250

    Office

    $600.65

    Facility

    $339.80

    $39.01 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 46250

    Office

    $686.58

    Facility

    $379.05

    $124.94 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 46250

    Office

    $685.63

    Facility

    $378.09

    $123.99 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 46250

    Office

    $702.67

    Facility

    $388.16

    $141.03 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 46250

    Office

    $698.77

    Facility

    $384.26

    $137.13 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 46250

    Office

    $577.57

    Facility

    $329.15

    $15.93 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 46250

    Office

    $606.28

    Facility

    $341.28

    $44.64 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 46250

    Office

    $589.10

    Facility

    $334.78

    $27.46 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 46250

    Office

    $612.34

    Facility

    $344.50

    $50.70 higher than Merced for the office setting.

  • Stockton

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 46250

    Office

    $648.08

    Facility

    $360.61

    $86.44 higher than Merced for the office setting.

  • Visalia

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 46250

    Office

    $561.64

    Facility

    $322.60

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 46250

    Office

    $613.32

    Facility

    $356.39

    $51.68 higher than Merced for the office setting.

  • Miami

    Florida · 46250

    Office

    $594.84

    Facility

    $367.79

    $33.20 higher than Merced for the office setting.

  • Chicago

    Illinois · 46250

    Office

    $575.91

    Facility

    $356.71

    $14.27 higher than Merced for the office setting.

  • Manhattan

    New York · 46250

    Office

    $622.05

    Facility

    $368.61

    $60.41 higher than Merced for the office setting.

  • Alaska*

    Alaska · 46250

    Office

    $617.37

    Facility

    $385.09

    $55.73 higher than Merced for the office setting.

  • Alabama

    Alabama · 46250

    Office

    $478.27

    Facility

    $287.43

    $83.37 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 46250

    Office

    $470.92

    Facility

    $283.56

    $90.72 lower than Merced for the office setting.

  • Arizona

    Arizona · 46250

    Office

    $521.23

    Facility

    $309.88

    $40.41 lower than Merced for the office setting.

  • Colorado

    Colorado · 46250

    Office

    $555.97

    Facility

    $323.91

    $5.67 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 46250

    Office

    $573.93

    Facility

    $339.03

    $12.29 higher than Merced for the office setting.

  • Delaware

    Delaware · 46250

    Office

    $530.17

    Facility

    $314.67

    $31.47 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 46250

    Office

    $564.24

    Facility

    $343.29

    $2.60 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 46250

    Office

    $534.57

    Facility

    $326.06

    $27.07 lower than Merced for the office setting.

  • Atlanta

    Georgia · 46250

    Office

    $548.73

    Facility

    $327.14

    $12.91 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 46250

    Office

    $502.13

    Facility

    $307.58

    $59.51 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 46250

    Office

    $575.69

    Facility

    $327.70

    $14.05 higher than Merced for the office setting.

  • Iowa

    Iowa · 46250

    Office

    $488.35

    Facility

    $288.78

    $73.29 lower than Merced for the office setting.

  • Idaho

    Idaho · 46250

    Office

    $492.33

    Facility

    $291.67

    $69.31 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 46250

    Office

    $535.57

    Facility

    $334.91

    $26.07 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 46250

    Office

    $520.32

    Facility

    $321.19

    $41.32 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 46250

    Office

    $569.38

    Facility

    $345.38

    $7.74 higher than Merced for the office setting.

  • Indiana

    Indiana · 46250

    Office

    $495.29

    Facility

    $293.10

    $66.35 lower than Merced for the office setting.

  • Kansas

    Kansas · 46250

    Office

    $487.28

    Facility

    $290.11

    $74.36 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 46250

    Office

    $493.25

    Facility

    $299.35

    $68.39 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 46250

    Office

    $518.71

    Facility

    $313.47

    $42.93 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 46250

    Office

    $492.98

    Facility

    $299.95

    $68.66 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 46250

    Office

    $611.20

    Facility

    $350.78

    $49.56 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 46250

    Office

    $552.90

    Facility

    $323.23

    $8.74 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 46250

    Office

    $572.65

    Facility

    $338.63

    $11.01 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 46250

    Office

    $540.28

    Facility

    $319.55

    $21.36 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 46250

    Office

    $496.51

    Facility

    $295.85

    $65.13 lower than Merced for the office setting.

  • Southern Maine

    Maine · 46250

    Office

    $523.07

    Facility

    $306.92

    $38.57 lower than Merced for the office setting.

  • Detroit

    Michigan · 46250

    Office

    $543.03

    Facility

    $332.56

    $18.61 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 46250

    Office

    $508.15

    Facility

    $309.01

    $53.49 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 46250

    Office

    $527.74

    Facility

    $303.31

    $33.90 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 46250

    Office

    $513.51

    Facility

    $308.71

    $48.13 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 46250

    Office

    $519.03

    Facility

    $311.39

    $42.61 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 46250

    Office

    $484.91

    Facility

    $296.90

    $76.73 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 46250

    Office

    $477.94

    Facility

    $290.15

    $83.70 lower than Merced for the office setting.

  • Montana**

    Montana · 46250

    Office

    $536.70

    Facility

    $318.59

    $24.94 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 46250

    Office

    $501.81

    Facility

    $298.31

    $59.83 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 46250

    Office

    $520.09

    Facility

    $301.98

    $41.55 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 46250

    Office

    $490.78

    Facility

    $289.47

    $70.86 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 46250

    Office

    $548.43

    Facility

    $321.38

    $13.21 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 46250

    Office

    $606.64

    Facility

    $353.63

    $45.00 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 46250

    Office

    $579.08

    Facility

    $340.91

    $17.44 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 46250

    Office

    $511.65

    Facility

    $311.64

    $49.99 lower than Merced for the office setting.

  • Nevada**

    Nevada · 46250

    Office

    $532.44

    Facility

    $314.11

    $29.20 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 46250

    Office

    $639.66

    Facility

    $380.33

    $78.02 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 46250

    Office

    $584.06

    Facility

    $345.23

    $22.42 higher than Merced for the office setting.

  • Queens

    New York · 46250

    Office

    $625.42

    Facility

    $367.62

    $63.78 higher than Merced for the office setting.

  • Rest Of New York

    New York · 46250

    Office

    $509.90

    Facility

    $302.70

    $51.74 lower than Merced for the office setting.

  • Ohio

    Ohio · 46250

    Office

    $504.75

    Facility

    $305.62

    $56.89 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 46250

    Office

    $490.86

    Facility

    $296.09

    $70.78 lower than Merced for the office setting.

  • Portland

    Oregon · 46250

    Office

    $572.90

    Facility

    $330.58

    $11.26 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 46250

    Office

    $526.94

    Facility

    $309.70

    $34.70 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 46250

    Office

    $559.84

    Facility

    $332.79

    $1.80 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 46250

    Office

    $504.84

    Facility

    $304.61

    $56.80 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 46250

    Office

    $540.41

    Facility

    $319.90

    $21.23 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 46250

    Office

    $548.57

    Facility

    $323.27

    $13.07 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 46250

    Office

    $504.39

    Facility

    $302.86

    $57.25 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 46250

    Office

    $518.12

    Facility

    $300.01

    $43.52 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 46250

    Office

    $490.05

    Facility

    $291.79

    $71.59 lower than Merced for the office setting.

  • Austin

    Texas · 46250

    Office

    $555.31

    Facility

    $324.56

    $6.33 lower than Merced for the office setting.

  • Beaumont

    Texas · 46250

    Office

    $501.42

    Facility

    $302.94

    $60.22 lower than Merced for the office setting.

  • Brazoria

    Texas · 46250

    Office

    $528.35

    Facility

    $312.21

    $33.29 lower than Merced for the office setting.

  • Dallas

    Texas · 46250

    Office

    $532.53

    Facility

    $315.30

    $29.11 lower than Merced for the office setting.

  • Fort Worth

    Texas · 46250

    Office

    $529.19

    Facility

    $314.14

    $32.45 lower than Merced for the office setting.

  • Galveston

    Texas · 46250

    Office

    $530.44

    Facility

    $313.86

    $31.20 lower than Merced for the office setting.

  • Houston

    Texas · 46250

    Office

    $545.82

    Facility

    $329.23

    $15.82 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 46250

    Office

    $515.14

    Facility

    $308.16

    $46.50 lower than Merced for the office setting.

  • Utah

    Utah · 46250

    Office

    $511.67

    Facility

    $306.64

    $49.97 lower than Merced for the office setting.

  • Virginia

    Virginia · 46250

    Office

    $522.21

    Facility

    $307.81

    $39.43 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 46250

    Office

    $540.41

    Facility

    $319.90

    $21.23 lower than Merced for the office setting.

  • Vermont

    Vermont · 46250

    Office

    $519.19

    Facility

    $303.26

    $42.45 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 46250

    Office

    $551.48

    Facility

    $321.81

    $10.16 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 46250

    Office

    $622.62

    Facility

    $355.00

    $60.98 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 46250

    Office

    $501.78

    Facility

    $292.83

    $59.86 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 46250

    Office

    $500.32

    Facility

    $310.78

    $61.32 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 46250

    Office

    $529.46

    Facility

    $311.35

    $32.18 lower than Merced for the office setting.

See how rates vary across the country

46250 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$470.92

$632.16

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$617.371
AL$478.271
AR$470.921
AZ$521.231
CA$561.64–$702.6729
CO$555.971
CT$573.931
DC$613.321
DE$530.171
FL$534.57–$594.843
GA$502.13–$548.732
GU$575.691
HI$575.691
IA$488.351
ID$492.331
IL$520.32–$575.914
IN$495.291
KS$487.281
KY$493.251
LA$492.98–$518.712
MA$552.90–$611.202
MD$540.28–$613.323
ME$496.51–$523.072
MI$508.15–$543.032
MN$527.741
MO$484.91–$519.033
MS$477.941
MT$536.701
NC$501.811
ND$520.091
NE$490.781
NH$548.431
NJ$579.08–$606.642
NM$511.651
NV$532.441
NY$509.90–$639.665
OH$504.751
OK$490.861
OR$526.94–$572.902
PA$504.84–$559.842
PR$540.411
RI$548.571
SC$504.391
SD$518.121
TN$490.051
TX$501.42–$555.318
UT$511.671
VA$522.21–$613.322
VI$540.411
VT$519.191
WA$551.48–$622.622
WI$501.781
WV$500.321
WY$529.461

Explore 46250 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 46250 in Merced, the physician’s office rate is $561.64 and the facility-setting rate is $322.60: a difference of $239.04.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 46250 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$617.80

$561.64 × 110% = $617.80

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.

Compare your contract offer →

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 46250 in Merced.

PPRRVU2026_Oct_nonQPP.csv

5,583

Code
46250
Physician work
4.14
Practice expense
11.09
Malpractice
0.84

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 46250 in Merced
ComponentRVULocality factorAdjusted
Physician work4.14× 1.0174.2104
Practice expense11.09× 1.09612.1546
Malpractice0.84× 0.5360.4502
Total RVUs16.8153
Conversion factor× 33.4009

Office / nonfacility rate, Merced$561.64

Open 46250 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.141.017
Practice expense11.091.096
Malpractice0.840.536

(4.14 × 1.017 + 11.09 × 1.096 + 0.84 × 0.536) × $33.4009 = $561.64

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.141.017
Practice expense4.561.096
Malpractice0.840.536

(4.14 × 1.017 + 4.56 × 1.096 + 0.84 × 0.536) × $33.4009 = $322.60

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

46250 · Office / nonfacility

$561.64

Effective 2026-10-01

The base rate is $73.99 higher than on 2025-10-01, moving from $487.65 to $561.64 (15.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $487.65changed to$561.64

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.25 changed to 4.14
    • Practice expense RVU 9.43 changed to 11.09
    • Malpractice RVU 0.82 changed to 0.84
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $487.65

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$561.64$322.60RVU26D
2026-07-01$561.64$322.60RVU26C
2026-04-01$561.64$322.60RVU26B
2026-01-01$561.64$322.60RVU26A
2025-10-01$487.65$320.06RVU25D
2025-07-01$487.65$320.06RVU25C
2025-04-01$487.65$320.06RVU25B
2025-01-01$487.65$320.06RVU25A

46250 billing questions

When is this code appropriate instead of 46255?

Use this code for excision of external hemorrhoids involving two or more groups. Code 46255 describes combined internal and external hemorrhoidectomy involving one group.

How does this differ from 46260?

Both describe hemorrhoidectomy involving two or more groups, but 46260 includes internal and external disease. This code is for external hemorrhoids.

Should the code be reported once for each group removed?

No. Report one unit for the qualifying excisional procedure; document that two or more external groups were treated.

Can modifier 50 be used when disease is on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code because its descriptor or anatomy makes modifier 50 unsuitable.

Are postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery 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 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.

RVUs for 46250PPRRVU2026_Oct_nonQPP.csv, line 5,583 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet