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CMS RVU26D · Effective 2026-10-01

46250 Hemorrhoidectomy Medicare reimbursement rates in Indiana

Reports excisional surgery for external hemorrhoids involving two or more groups, rather than a single group or internal-and-external disease. Compare 46250 office and facility rates across CMS payment localities in Indiana.

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.

What does Medicare pay for 46250 in Indiana?

Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

$495.29

1 of 1 localities have a supported rate.

Payment area: Indiana

One mapped payment locality.

Facility setting

$293.10

1 of 1 localities have a supported rate.

Payment area: Indiana

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 46250 in your payment locality →

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 Indiana, from the same CMS release.

46255

Hemorrhoidectomy

One internal and external group

$536.84

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

$302.19

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

46230

Anal tag excision

Multiple tags

$316.51

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

Compare 46250 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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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 Indiana.

PPRRVU2026_Oct_nonQPP.csv

5,583

Code
46250
Physician work
4.14
Practice expense
11.09
Malpractice
0.84

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Office / nonfacility calculation for 46250 in Indiana
ComponentRVULocality factorAdjusted
Physician work4.14× 1.0004.1400
Practice expense11.09× 0.92710.2804
Malpractice0.84× 0.4860.4082
Total RVUs14.8287
Conversion factor× 33.4009

Office / nonfacility rate, Indiana$495.29

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.141
Practice expense11.090.927
Malpractice0.840.486

(4.14 × 1 + 11.09 × 0.927 + 0.84 × 0.486) × $33.4009 = $495.29

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.141
Practice expense4.560.927
Malpractice0.840.486

(4.14 × 1 + 4.56 × 0.927 + 0.84 × 0.486) × $33.4009 = $293.10

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.

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 IndianaGPCI2026.csv, line 52 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet