Billing code 46260: HemorrhoidectomyMedicare rate & RVUs in Massachusetts
Reports surgical removal of internal and external hemorrhoids involving two or more groups, when both tissue types are treated during the procedure.
CMS doesn’t publish an office rate for 46260 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 46260 covers
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.
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.
Where 46260 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $525.56 |
| Rest Of Massachusetts | Unavailable | $485.49 |
How the 46260 rate is calculated
Each of 46260’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 46260
RVUs × geographic indexes × conversion factor
Work6.56
6.56 RVUs× 1.000 GPCI
Practice expense6.46
6.46 RVUs× 1.000 GPCI
Malpractice1.34
1.34 RVUs× 1.000 GPCI
Adjusted RVUs
14.3600
Conversion factor
$33.4009
Medicare rate
$479.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46260
46260 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46260
Hemorrhoidectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 46260
Hemorrhoidectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
46260 without 51 · national facility
$479.64
Hemorrhoidectomy
46260-51 · Second procedure: 50%
$239.82
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
46260 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46250Hemorrhoidectomy
- 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.
- 46255Hemorrhoidectomy
- Both codes cover internal and external hemorrhoidal tissue, but 46255 is for one group; 46260 is for two or more.
- 46261Hemorrhoidectomy
- 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.
- 46221Hemorrhoid ligation
- 46221 reports ligation of hemorrhoids rather than excisional removal. Select according to the treatment actually performed.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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