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See a sample rate comparisonCPT 46221 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Hemorrhoid Removal, Removal Of One Or More Hemorrhoids Inside The Anus By Cutting Off The Blood Supply To The Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46221 |
| Medicaid Fee Schedule | View Medicaid rates for 46221 |
National average reimbursement for CPT 46221 by major payers:
$324.60
$341.71
$384.62
$437.45
Compare published rates across providers.
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CPT 46221
5 of 25 sample ratesHigher to lower in this preview
Aria Health Bucks County Spu
Jefferson Health-Northeast
$1,927.00Published rateSalmon Surgery Center LLC
$953.00Published rateJewett Orthopedic Institute Surgery Center, LLC
Jewett Orthopedic Institute Surgery Center LLC
$725.00Published rateUPMC Hamot Surgery Center, LLC
UPMC Hamot Surgery Center, L.L.C.
$424.00Published rateNew Vision Surgical Center, LLC
New Vision Surgical Center LLC
$231.00Published rate
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See a sample payer proposalCPT 46221 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46221 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 46221 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 46220-CPT | Moderate | Remove Skin Tag Near Anus, Surgery To Remove One Or More Skin Tags (Tiny Hanging Growths) Or Bumps Near The Anus. |
| 46221-CPT | Moderate | Hemorrhoid Removal, Removal Of One Or More Hemorrhoids Inside The Anus By Cutting Off The Blood Supply To The Tissue. |
| 46230-CPT | Moderate | Remove Skin Tag Near Anus, Surgery To Remove One Or More Skin Tags (Tiny Hanging Growths) Or Bumps Near The Anus. |
| 46250-CPT | Moderate | Hemorrhoid Surgery, Surgery To Remove One Or More Internal Or External Hemorrhoids. The Procedure May Include Repairing Nearby Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46221 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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