Billing code 46250: HemorrhoidectomyMedicare rate & RVUs in Utah

Reports excisional surgery for external hemorrhoids involving two or more groups, rather than a single group or internal-and-external disease.

CMS RVU26DEffective Oct 1, 20261 payment locality868 Medicare services in 2024

Medicare pays $511.67 for 46250 in the office in Utah (Utah). Which amount applies depends on the service address.

$511.67Office (non-facility)
$306.64Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 46250 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 46250 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 46250 covers

This code describes operative excision of external hemorrhoids in two or more groups. It is typically performed by a colorectal or general surgeon for symptomatic external hemorrhoidal disease requiring removal, often in a surgical facility. The operative report should identify the external disease treated and document excision involving multiple groups; a procedure limited to anal tags or to hemorrhoid ligation is a different service.

Report the code once for the qualifying excision, not once per group. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. If other procedures are performed 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 for this code. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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.

46250 in Utah

46250 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$511.67$306.64

How the 46250 rate is calculated

Each of 46250’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 · 46250

RVUs × geographic indexes × conversion factor

Work4.14

4.14 RVUs× 1.000 GPCI

Practice expense11.09

11.09 RVUs× 1.000 GPCI

Malpractice0.84

0.84 RVUs× 1.000 GPCI

Adjusted RVUs

16.0700

Conversion factor

$33.4009

Medicare rate

$536.75

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 46250

46250 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46250

Hemorrhoidectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46250

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46250 without 51 · national office

$536.75

Hemorrhoidectomy

46250-51 · Second procedure: 50%

$268.38

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%).

When to use modifier 51

46250 compared with similar codes

Compare codes · National

5 codes, side by side

  • 46250

    Hemorrhoidectomy4.14 wRVU

    $536.75

  • 46255

    Hemorrhoidectomy4.84 wRVU

    $580.84+$44.09

  • 46260

    Hemorrhoidectomy6.56 wRVU

    Not priced

  • 46221

    Hemorrhoid ligation2.3 wRVU

    $325.66−$211.09

  • 46230

    Anal tag excision2.55 wRVU

    $342.36−$194.39

How to choose

46255Hemorrhoidectomy
46255 is for combined internal and external hemorrhoidectomy involving one group. This code is for external hemorrhoids involving two or more groups.
46260Hemorrhoidectomy
46260 includes excision of internal and external hemorrhoids in two or more groups; this code addresses external hemorrhoids only.
46221Hemorrhoid ligation
46221 reports hemorrhoid ligation, not excisional removal of multiple external hemorrhoid groups.
46230Anal tag excision
46230 is for excision of multiple anal tags. Use this code when the operative service is hemorrhoidectomy involving multiple external groups.

46250 billing questions

When is this code appropriate instead of 46255?

Use this code for excision of external hemorrhoids involving two or more groups. Code 46255 describes combined internal and external hemorrhoidectomy involving one group.

How does this differ from 46260?

Both describe hemorrhoidectomy involving two or more groups, but 46260 includes internal and external disease. This code is for external hemorrhoids.

Should the code be reported once for each group removed?

No. Report one unit for the qualifying excisional procedure; document that two or more external groups were treated.

Can modifier 50 be used when disease is on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code because its descriptor or anatomy makes modifier 50 unsuitable.

Are postoperative visits separately reported?

Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. 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
RVUs for 46250PPRRVU2026_Oct_nonQPP.csv, line 5,583 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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