No office rate
Use 46945 for ligation of one internal hemorrhoid. Use 46947 when the surgeon performs stapled hemorrhoidopexy to reposition prolapsing tissue.
On this page
CMS RVU26D · Effective 2026-10-01
46947 Hemorrhoidopexy Medicare reimbursement rates in Rhode Island
Reports stapled repositioning of prolapsing internal hemorrhoidal tissue, typically performed surgically for symptomatic internal hemorrhoidal prolapse. Compare 46947 office and facility rates across CMS payment localities in Rhode Island.
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 46947 in Rhode Island?
Rhode Island 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
No supported rate
Facility setting
$383.67
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 surgery
About 46947: Stapled hemorrhoidopexy for prolapse
Reports stapled repositioning of prolapsing internal hemorrhoidal tissue, typically performed surgically for symptomatic internal hemorrhoidal prolapse.
Stapled hemorrhoidopexy treats prolapsing internal hemorrhoidal tissue by removing a circumferential ring of rectal mucosa and submucosa above the hemorrhoids with a circular stapling device, lifting the prolapsed tissue toward its anatomic position. A colorectal or general surgeon typically performs the operation in an operating-room setting for symptomatic internal hemorrhoidal prolapse. This code describes the stapled approach, rather than banding or destruction of individual hemorrhoids.
Report 46947 when the operative technique is stapled hemorrhoidopexy; selection is based on the procedure, not the number of hemorrhoidal columns. The operative note should identify the prolapsing internal hemorrhoids and document the stapled technique and relevant findings. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures 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. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 46947
- 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 RVU5.43 · 48%
- Practice expense (office) RVU4.71 · 41%
- Malpractice RVU1.22 · 11%
943
Medicare services in 2024 · #3015 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.
46947 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
46946 reports ligation of two or more internal hemorrhoids. It is not selected for stapled hemorrhoidopexy, regardless of the number of columns treated.
No office rate
46948 describes transanal hemorrhoidal dearterialization for multiple hemorrhoids. Choose between it and 46947 according to the operative technique documented.
No office rate
46260 describes excisional removal of multiple internal and external hemorrhoidal columns or groups. Code 46947 describes the stapled repositioning approach.
Compare 46947 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$383.67
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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 46947 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
5,641
- Code
- 46947
- Physician work
- 5.43
- Practice expense
- 4.71
- Malpractice
- 1.22
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.43 | × 1.019 | 5.5332 |
| Practice expense | 4.71 | × 1.033 | 4.8654 |
| Malpractice | 1.22 | × 0.892 | 1.0882 |
| Total RVUs | 11.4868 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$383.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.43 | 1.019 |
| Practice expense | 4.71 | 1.033 |
| Malpractice | 1.22 | 0.892 |
(5.43 × 1.019 + 4.71 × 1.033 + 1.22 × 0.892) × $33.4009 = $383.67
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.
46947 billing questions
How does 46947 differ from hemorrhoid ligation codes 46945 and 46946?
46947 is for stapled hemorrhoidopexy to reposition prolapsing internal tissue. Codes 46945 and 46946 describe ligation of internal hemorrhoids and distinguish one hemorrhoid from two or more.
Should 46947 be selected based on the number of hemorrhoidal columns?
No. Select 46947 based on the stapled hemorrhoidopexy technique, not a column count. The operative note should support that technique.
Are related postoperative visits separately reported?
Related postoperative care is included in the 90-day global period, along with the day-before preoperative visit.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
How does 46947 differ from excisional hemorrhoidectomy?
46947 describes stapled repositioning of prolapsing internal tissue. Codes such as 46255 and 46260 describe excisional hemorrhoidectomy, including removal of internal and external hemorrhoidal tissue.
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.
5,63846942,,Treatment of anal fissure,A,,2.02,6.01,,1.39,,0.29,8.32,3.70,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63946945,,Int hrhc lig 1 hroid w/o img,A,,3.60,6.27,NA,6.27,,0.62,10.49,10.49,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,64046946,,Int hrhc lig 2+hroid w/o img,A,,4.39,6.43,NA,6.43,,0.67,11.49,11.49,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,64146947,,Hemorrhoidopexy by stapling,A,,5.43,4.71,NA,4.71,,1.22,11.36,11.36,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,64246948,,Int hrhc tranal dartlzj 2+,A,,5.43,6.82,NA,6.82,,1.09,13.34,13.34,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,64346999,,Unlisted procedure anus,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,64447000,,Needle biopsy of liver perq,A,,1.61,6.84,,0.51,,0.17,8.62,2.29,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537