$496.51–$523.07
Use 46250 when the operation removes external hemorrhoidal groups only. Use 46260 when both internal and external tissue are removed from two or more groups.
On this page
CMS RVU26D · Effective 2026-10-01
46260 Hemorrhoidectomy Medicare reimbursement rates in Maine
Reports surgical removal of internal and external hemorrhoids involving two or more groups, when both tissue types are treated during the procedure. Compare 46260 office and facility rates across CMS payment localities in Maine.
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 46260 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$445.46–$461.18
2 of 2 localities have a supported rate.
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.
Colorectal surgery
About 46260: Internal and external hemorrhoidectomy, multiple groups
Reports surgical removal of internal and external hemorrhoids involving two or more groups, when both tissue types are treated during the procedure.
This code describes operative removal of hemorrhoidal tissue involving both the internal and external components in at least two groups. It is typically performed by a colorectal or general surgeon, often in an operating room, for symptomatic hemorrhoids selected for surgical treatment. The operative report should make clear that both internal and external hemorrhoidal tissue were removed and document the number of groups treated.
Choose this code based on the tissue treated and the number of groups, not simply the number of individual hemorrhoids. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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 50% multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 46260
- 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 RVU6.56 · 46%
- Practice expense (office) RVU6.46 · 45%
- Malpractice RVU1.34 · 9%
7.6K
Medicare services in 2024 · #1613 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.
46260 compared with similar codes
Office rates for Maine, from the same CMS release.
$538.25–$566.13
Both codes cover internal and external hemorrhoidal tissue, but 46255 is for one group; 46260 is for two or more.
No office rate
46261 includes a fissurectomy with removal of internal and external hemorrhoids from two or more groups. Without that accompanying fissurectomy, the multiple-group procedure is 46260.
$302.17–$319.09
46221 reports ligation of hemorrhoids rather than excisional removal. Select according to the treatment actually performed.
Compare 46260 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$445.46
Southern Maine →
Office / nonfacility
Unavailable
Facility
$461.18
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46260 billing questions
How does this differ from code 46255?
Code 46255 applies when both internal and external hemorrhoidal tissue are removed from one group. Use 46260 when two or more groups are treated.
When should 46250 be considered instead?
Code 46250 describes removal of external hemorrhoidal groups only. This code requires removal of both internal and external hemorrhoidal tissue.
What documentation supports reporting 46260?
The operative report should identify removal of internal and external hemorrhoidal tissue and document treatment of at least two groups. Record any associated fissure or fistula procedure when performed.
Can modifier 50 be used when hemorrhoids are on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
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% when performed in the same session.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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.
5,58446255,,Remove int/ext hem 1 group,A,,4.84,11.64,,4.75,,0.91,17.39,10.50,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,58546257,,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