$324.06
Use 46500 for injection of a sclerosing agent; use 46221 when hemorrhoids are treated by rubber-band ligation.
On this page
CMS RVU26D · Effective 2026-10-01
46500 Hemorrhoid injection Medicare reimbursement rates in Minnesota
Injection of a sclerosing agent into internal hemorrhoids to treat symptomatic hemorrhoidal disease is reported for office or outpatient treatment. Compare 46500 office and facility rates across CMS payment localities in Minnesota.
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 46500 in Minnesota?
Minnesota 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
$360.18
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$191.77
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Anorectal procedure
About 46500: Hemorrhoid sclerotherapy injection
Injection of a sclerosing agent into internal hemorrhoids to treat symptomatic hemorrhoidal disease is reported for office or outpatient treatment.
This service involves injecting a sclerosing agent into internal hemorrhoidal tissue, commonly to address bleeding or prolapsing hemorrhoids. A colorectal or general surgeon, or another clinician trained in anorectal procedures, may perform it in an office or outpatient setting. It is distinct from injecting medication into the anal sphincter, which targets a different condition and structure.
Documentation should identify the symptoms and examination findings supporting treatment, the hemorrhoid(s) treated, and the injection procedure performed. CMS assigns different practice-expense inputs for office and facility settings. The service has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate. Medicare does not pay an assistant at surgery, and co-surgeon or team-surgery reporting is not permitted.
CMS billing rules for 46500
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.70 · 16%
- Practice expense (office) RVU8.75 · 82%
- Malpractice RVU0.27 · 3%
13.3K
Medicare services in 2024 · #1325 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.
46500 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$248.11
46500 describes injection treatment. Code 46930 describes destruction of internal hemorrhoids using thermal energy.
$336.16
46500 targets hemorrhoidal tissue. Code 46505 targets the anal sphincter muscle for chemodenervation, such as treatment of sphincter spasm.
$570.72
46500 is an injection treatment; 46255 describes surgical excision of internal and external hemorrhoidal tissue in a single column or group.
Compare 46500 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
Minnesota →
Office / nonfacility
$360.18
Facility
$191.77
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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 46500 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
5,596
- Code
- 46500
- Physician work
- 1.70
- Practice expense
- 8.75
- Malpractice
- 0.27
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.70 | × 1.000 | 1.7000 |
| Practice expense | 8.75 | × 1.029 | 9.0038 |
| Malpractice | 0.27 | × 0.296 | 0.0799 |
| Total RVUs | 10.7837 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$360.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.7 | 1 |
| Practice expense | 8.75 | 1.029 |
| Malpractice | 0.27 | 0.296 |
(1.7 × 1 + 8.75 × 1.029 + 0.27 × 0.296) × $33.4009 = $360.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.7 | 1 |
| Practice expense | 3.85 | 1.029 |
| Malpractice | 0.27 | 0.296 |
(1.7 × 1 + 3.85 × 1.029 + 0.27 × 0.296) × $33.4009 = $191.77
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.
46500 billing questions
When should 46500 be chosen instead of hemorrhoid banding?
Report 46500 when a sclerosing agent is injected into hemorrhoidal tissue. Rubber-band ligation is a different treatment method reported with 46221.
Is the code reported once for each hemorrhoid or injection?
The code describes injection treatment of hemorrhoid(s). Document the treated site or sites and the service performed; do not create separate units for individual needle passes.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can modifier 50 be used when hemorrhoids are treated on both sides?
No. Modifier 50 is not appropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting 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.
5,59346285,,Remove anal fist 2 stage,A,,5.28,12.62,,6.51,,0.99,18.89,12.78,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59446288,,Repair anal fistula,A,,7.61,7.50,NA,7.50,,1.43,16.54,16.54,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59546320,,Removal of hemorrhoid clot,A,,1.60,5.08,,1.36,,0.28,6.96,3.24,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59646500,,Injection into hemorrhoid(s),A,,1.70,8.75,,3.85,,0.27,10.72,5.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59746505,,Chemodenervation anal musc,A,,3.10,6.61,,3.73,,0.55,10.26,7.38,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59846600,,Diagnostic anoscopy spx,A,,0.54,3.24,,0.59,,0.08,3.86,1.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59946601,,Diagnostic anoscopy,A,,1.56,3.20,,0.79,,0.21,4.97,2.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002