$211.08–$235.04
Use 46083 for incision of the thrombosed external hemorrhoid; use 46320 when the lesion is excised.
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CMS RVU26D · Effective 2026-10-01
46320 Hemorrhoid excision Medicare reimbursement rates in Pennsylvania
Report this service for excision of a thrombosed external hemorrhoid, typically to treat a painful, localized perianal lump. Compare 46320 office and facility rates across CMS payment localities in Pennsylvania.
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 46320 in Pennsylvania?
Pennsylvania 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
$218.04–$242.19
2 of 2 localities have a supported rate.
Facility setting
$103.98–$112.85
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.
Anorectal surgery
About 46320: Excision of thrombosed external hemorrhoid
Report this service for excision of a thrombosed external hemorrhoid, typically to treat a painful, localized perianal lump.
The service removes a thrombosed external hemorrhoid rather than simply opening it to release the clot. It is commonly performed by a surgeon or other qualified clinician for an acutely painful, palpable perianal lump, often in an office or outpatient setting. The operative note should make clear that excision was performed and identify the treated external hemorrhoidal lesion; an incision alone is a different service.
Report 46320 when the documented procedure is excision of the thrombosed external hemorrhoid, not a broader hemorrhoidectomy involving hemorrhoidal columns. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures 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-surgeons and team surgery are not permitted.
CMS billing rules for 46320
- 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 RVU1.60 · 23%
- Practice expense (office) RVU5.08 · 73%
- Malpractice RVU0.28 · 4%
1.5K
Medicare services in 2024 · #2689 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.
46320 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$504.84–$559.84
46250 describes an external hemorrhoidectomy involving multiple columns or groups, rather than excision of a thrombosed external hemorrhoid.
$547.29–$605.56
46255 describes hemorrhoidectomy involving internal and external hemorrhoidal disease; 46320 is for excision of a thrombosed external hemorrhoid.
Compare 46320 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
Metropolitan Philadelphia →
Office / nonfacility
$242.19
Facility
$112.85
Rest Of Pennsylvania →
Office / nonfacility
$218.04
Facility
$103.98
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46320 billing questions
How is 46320 different from 46083?
46320 is for excision of the thrombosed external hemorrhoid. 46083 describes incision of a thrombosed external hemorrhoid, so the documented technique determines which code fits.
Can related postoperative visits be billed separately?
Related postoperative visits during the 10-day global period are included in 46320.
Should modifier 50 be appended for hemorrhoids on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures 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 46320. 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.
5,59246280,,Remove anal fist complex,A,,6.23,7.06,NA,7.06,,1.16,14.45,14.45,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59346285,,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