No office rate
Both include fissurectomy, but 46257 applies to one hemorrhoidal group. 46261 requires two or more groups.
On this page
CMS RVU26D · Effective 2026-10-01
46261 in Redding
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$517.94
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.
Colorectal surgery
About 46261: Multiple-group hemorrhoidectomy with fissurectomy
Reports excision of internal and external hemorrhoidal disease in two or more groups when an anal fissure is also excised during the operation.
Code 46261 represents excision of internal and external hemorrhoidal disease involving two or more columns or groups, performed with excision of an anal fissure. A colorectal or general surgeon typically performs the operation in an operating room for symptomatic hemorrhoids requiring excision when a fissure is also treated surgically.
Report it when the operative record supports both the multiple-group hemorrhoidectomy and fissurectomy; document the number of groups and the fissure treatment. The fissurectomy is part of this combined service, so do not separately report 46200 for that same fissure. The 90-day global includes the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 46261
- 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 RVU7.57 · 49%
- Practice expense (office) RVU6.42 · 42%
- Malpractice RVU1.44 · 9%
185
Medicare services in 2024 · #4387 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.
46261 compared with similar codes
Office rates for Redding, from the same CMS release.
No office rate
Both cover internal and external hemorrhoidectomy involving two or more groups. 46261 also includes fissurectomy; 46260 does not.
No office rate
This code pairs the multiple-group hemorrhoidectomy with fistulectomy. 46261 pairs it with fissurectomy.
$561.23
46200 is for fissure excision without the combined multiple-group hemorrhoidectomy reported by 46261.
The same code, a different location
How does Redding compare?
46261 across payment areas
Same release and payment basis · bars start at $0
Redding · 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
Madera
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Merced
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Modesto
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Napa
California · 46261
Office
Unavailable
Facility
$575.83
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 46261
Office
Unavailable
Facility
$543.35
No comparable office rate is available.
Rest Of California
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 46261
Office
Unavailable
Facility
$533.44
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 46261
Office
Unavailable
Facility
$537.11
No comparable office rate is available.
Salinas
California · 46261
Office
Unavailable
Facility
$534.99
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 46261
Office
Unavailable
Facility
$542.96
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 46261
Office
Unavailable
Facility
$601.29
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 46261
Office
Unavailable
Facility
$599.66
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 46261
Office
Unavailable
Facility
$615.65
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 46261
Office
Unavailable
Facility
$608.97
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 46261
Office
Unavailable
Facility
$527.16
No comparable office rate is available.
Santa Cruz-Watsonville
California · 46261
Office
Unavailable
Facility
$544.47
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 46261
Office
Unavailable
Facility
$535.73
No comparable office rate is available.
Santa Rosa-Petaluma
California · 46261
Office
Unavailable
Facility
$549.53
No comparable office rate is available.
Stockton
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Vallejo
California · 46261
Office
Unavailable
Facility
$573.47
No comparable office rate is available.
Visalia
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Yuba City
California · 46261
Office
Unavailable
Facility
$517.94
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 46261
Office
Unavailable
Facility
$572.63
No comparable office rate is available.
Miami
Florida · 46261
Office
Unavailable
Facility
$597.71
No comparable office rate is available.
Chicago
Illinois · 46261
Office
Unavailable
Facility
$580.50
No comparable office rate is available.
Manhattan
New York · 46261
Office
Unavailable
Facility
$594.48
No comparable office rate is available.
Alaska*
Alaska · 46261
Office
Unavailable
Facility
$634.14
No comparable office rate is available.
Alabama
Alabama · 46261
Office
Unavailable
Facility
$467.70
No comparable office rate is available.
Arkansas
Arkansas · 46261
Office
Unavailable
Facility
$461.81
No comparable office rate is available.
Arizona
Arizona · 46261
Office
Unavailable
Facility
$501.80
No comparable office rate is available.
Colorado
Colorado · 46261
Office
Unavailable
Facility
$521.60
No comparable office rate is available.
Connecticut
Connecticut · 46261
Office
Unavailable
Facility
$547.04
No comparable office rate is available.
Delaware
Delaware · 46261
Office
Unavailable
Facility
$509.21
No comparable office rate is available.
Fort Lauderdale
Florida · 46261
Office
Unavailable
Facility
$557.03
No comparable office rate is available.
Rest Of Florida
Florida · 46261
Office
Unavailable
Facility
$530.13
No comparable office rate is available.
Atlanta
Georgia · 46261
Office
Unavailable
Facility
$529.23
No comparable office rate is available.
Rest Of Georgia
Georgia · 46261
Office
Unavailable
Facility
$501.45
No comparable office rate is available.
Hawaii, Guam
Hawaii · 46261
Office
Unavailable
Facility
$524.50
No comparable office rate is available.
Iowa
Iowa · 46261
Office
Unavailable
Facility
$468.15
No comparable office rate is available.
Idaho
Idaho · 46261
Office
Unavailable
Facility
$472.87
No comparable office rate is available.
East St. Louis
Illinois · 46261
Office
Unavailable
Facility
$546.99
No comparable office rate is available.
Rest Of Illinois
Illinois · 46261
Office
Unavailable
Facility
$523.80
No comparable office rate is available.
Suburban Chicago
Illinois · 46261
Office
Unavailable
Facility
$560.07
No comparable office rate is available.
Indiana
Indiana · 46261
Office
Unavailable
Facility
$475.00
No comparable office rate is available.
Kansas
Kansas · 46261
Office
Unavailable
Facility
$470.93
No comparable office rate is available.
Kentucky
Kentucky · 46261
Office
Unavailable
Facility
$487.49
No comparable office rate is available.
New Orleans
Louisiana · 46261
Office
Unavailable
Facility
$509.27
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 46261
Office
Unavailable
Facility
$488.70
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 46261
Office
Unavailable
Facility
$562.05
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 46261
Office
Unavailable
Facility
$521.02
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 46261
Office
Unavailable
Facility
$546.47
No comparable office rate is available.
Rest Of Maryland
Maryland · 46261
Office
Unavailable
Facility
$516.53
No comparable office rate is available.
Rest Of Maine
Maine · 46261
Office
Unavailable
Facility
$480.04
No comparable office rate is available.
Southern Maine
Maine · 46261
Office
Unavailable
Facility
$495.70
No comparable office rate is available.
Detroit
Michigan · 46261
Office
Unavailable
Facility
$540.87
No comparable office rate is available.
Rest Of Michigan
Michigan · 46261
Office
Unavailable
Facility
$502.92
No comparable office rate is available.
Minnesota
Minnesota · 46261
Office
Unavailable
Facility
$487.73
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 46261
Office
Unavailable
Facility
$501.19
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 46261
Office
Unavailable
Facility
$505.18
No comparable office rate is available.
Rest Of Missouri
Missouri · 46261
Office
Unavailable
Facility
$484.53
No comparable office rate is available.
Mississippi
Mississippi · 46261
Office
Unavailable
Facility
$473.02
No comparable office rate is available.
Montana**
Montana · 46261
Office
Unavailable
Facility
$515.28
No comparable office rate is available.
North Carolina
North Carolina · 46261
Office
Unavailable
Facility
$483.65
No comparable office rate is available.
North Dakota**
North Dakota · 46261
Office
Unavailable
Facility
$486.81
No comparable office rate is available.
Nebraska
Nebraska · 46261
Office
Unavailable
Facility
$468.95
No comparable office rate is available.
New Hampshire
New Hampshire · 46261
Office
Unavailable
Facility
$518.16
No comparable office rate is available.
Northern Nj
New Jersey · 46261
Office
Unavailable
Facility
$568.89
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 46261
Office
Unavailable
Facility
$549.88
No comparable office rate is available.
New Mexico
New Mexico · 46261
Office
Unavailable
Facility
$507.25
No comparable office rate is available.
Nevada**
Nevada · 46261
Office
Unavailable
Facility
$507.56
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 46261
Office
Unavailable
Facility
$613.31
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 46261
Office
Unavailable
Facility
$557.23
No comparable office rate is available.
Queens
New York · 46261
Office
Unavailable
Facility
$591.84
No comparable office rate is available.
Rest Of New York
New York · 46261
Office
Unavailable
Facility
$490.37
No comparable office rate is available.
Ohio
Ohio · 46261
Office
Unavailable
Facility
$497.10
No comparable office rate is available.
Oklahoma
Oklahoma · 46261
Office
Unavailable
Facility
$481.71
No comparable office rate is available.
Portland
Oregon · 46261
Office
Unavailable
Facility
$530.91
No comparable office rate is available.
Rest Of Oregon
Oregon · 46261
Office
Unavailable
Facility
$500.23
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 46261
Office
Unavailable
Facility
$538.00
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 46261
Office
Unavailable
Facility
$495.15
No comparable office rate is available.
Puerto Rico
Puerto Rico · 46261
Office
Unavailable
Facility
$517.01
No comparable office rate is available.
Rhode Island
Rhode Island · 46261
Office
Unavailable
Facility
$522.06
No comparable office rate is available.
South Carolina
South Carolina · 46261
Office
Unavailable
Facility
$491.86
No comparable office rate is available.
South Dakota**
South Dakota · 46261
Office
Unavailable
Facility
$483.44
No comparable office rate is available.
Tennessee
Tennessee · 46261
Office
Unavailable
Facility
$473.59
No comparable office rate is available.
Austin
Texas · 46261
Office
Unavailable
Facility
$522.84
No comparable office rate is available.
Beaumont
Texas · 46261
Office
Unavailable
Facility
$492.66
No comparable office rate is available.
Brazoria
Texas · 46261
Office
Unavailable
Facility
$504.89
No comparable office rate is available.
Dallas
Texas · 46261
Office
Unavailable
Facility
$509.96
No comparable office rate is available.
Fort Worth
Texas · 46261
Office
Unavailable
Facility
$508.44
No comparable office rate is available.
Galveston
Texas · 46261
Office
Unavailable
Facility
$507.62
No comparable office rate is available.
Houston
Texas · 46261
Office
Unavailable
Facility
$533.98
No comparable office rate is available.
Rest Of Texas
Texas · 46261
Office
Unavailable
Facility
$499.77
No comparable office rate is available.
Utah
Utah · 46261
Office
Unavailable
Facility
$497.60
No comparable office rate is available.
Virginia
Virginia · 46261
Office
Unavailable
Facility
$497.59
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 46261
Office
Unavailable
Facility
$517.01
No comparable office rate is available.
Vermont
Vermont · 46261
Office
Unavailable
Facility
$489.47
No comparable office rate is available.
Rest Of Washington
Washington · 46261
Office
Unavailable
Facility
$518.53
No comparable office rate is available.
Seattle (King Cnty)
Washington · 46261
Office
Unavailable
Facility
$567.89
No comparable office rate is available.
Wisconsin
Wisconsin · 46261
Office
Unavailable
Facility
$473.09
No comparable office rate is available.
West Virginia
West Virginia · 46261
Office
Unavailable
Facility
$508.01
No comparable office rate is available.
Wyoming**
Wyoming · 46261
Office
Unavailable
Facility
$502.87
No comparable office rate is available.
See how rates vary across the country
46261 · 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?
Redding is a Medicare payment area. Our Census mapping connects it to 32 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 46261 in Redding. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$569.73
$517.94 × 110% = $569.73
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 46261 in Redding.
PPRRVU2026_Oct_nonQPP.csv
5,588
- Code
- 46261
- Physician work
- 7.57
- Practice expense
- 6.42
- Malpractice
- 1.44
GPCI2026.csv
19
- Locality
- Redding
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.57 | × 1.017 | 7.6987 |
| Practice expense | 6.42 | × 1.096 | 7.0363 |
| Malpractice | 1.44 | × 0.536 | 0.7718 |
| Total RVUs | 15.5068 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Redding$517.94
Open 46261 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.57 | 1.017 |
| Practice expense | 6.42 | 1.096 |
| Malpractice | 1.44 | 0.536 |
(7.57 × 1.017 + 6.42 × 1.096 + 1.44 × 0.536) × $33.4009 = $517.94
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
46261 · 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 | $517.94 | RVU26D |
| 2026-07-01 | Not available in this setting | $517.94 | RVU26C |
| 2026-04-01 | Not available in this setting | $517.94 | RVU26B |
| 2026-01-01 | Not available in this setting | $517.94 | RVU26A |
| 2025-10-01 | Not available in this setting | $527.92 | RVU25D |
| 2025-07-01 | Not available in this setting | $527.92 | RVU25C |
| 2025-04-01 | Not available in this setting | $527.92 | RVU25B |
| 2025-01-01 | Not available in this setting | $527.92 | RVU25A |
46261 billing questions
How does 46261 differ from 46257?
Both include hemorrhoidectomy with fissurectomy. Use 46261 for two or more hemorrhoidal groups; 46257 is for one group.
Can the fissurectomy also be reported as 46200?
Do not separately report 46200 for the fissure excised as part of the 46261 operation.
When is 46260 a better choice?
Use 46260 for internal and external hemorrhoidectomy involving two or more groups when the operation does not include fissurectomy.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports 46261?
The operative note should describe internal and external hemorrhoidal disease, the two-or-more group extent, and the fissure excision.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
5,58546257,,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
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
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536
2001112,CA,62,RIVERSIDE-SAN BERNARDINO-ONTARIO,1.018,1.096,0.853
2101112,CA,63,SACRAMENTO-ROSEVILLE-FOLSOM,1.036,1.163,0.536
2201112,CA,64,SALINAS,1.031,1.159,0.536