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See a sample rate comparisonCPT 46255 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 Surgery, Surgery To Remove One Or More Internal Or External Hemorrhoids. The Procedure May Include Repairing Nearby Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46255 |
| Medicaid Fee Schedule | View Medicaid rates for 46255 |
National average reimbursement for CPT 46255 by major payers:
$611.90
$661.71
$723.57
$583.53
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CPT 46255
5 of 25 sample ratesHigher to lower in this preview
Florham Park Endoscopy Asc LLC, Florham Park Endoscopy Center
Florham Park Endoscopy Center, LLC
$2,795.00Published rateCentral Jersey Surgery Center LLC, Central Jersey Surgery Center
Central Jersey Surgery Center LLC
$2,307.00Published rateWoodhams Laser & Lens Implant Center LLC
Woodhams Laser Lens Implant Center LLC
$1,317.00Published rateMarlon Jordan
Deaconess Hospital Inc
$892.80Published rateEye Surgery Center Of East Texas LLC
$588.00Published rate
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See a sample payer proposalCPT 46255 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46255 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 46255 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 |
|---|---|---|
| 46221-CPT | Moderate | Hemorrhoid Removal, Removal Of One Or More Hemorrhoids Inside The Anus By Cutting Off The Blood Supply To The Tissue. |
| 46250-CPT | Moderate | Hemorrhoid Surgery, Surgery To Remove One Or More Internal Or External Hemorrhoids. The Procedure May Include Repairing Nearby Tissue. |
| 46255-CPT | Moderate | Hemorrhoid Surgery, Surgery To Remove One Or More Internal Or External Hemorrhoids. The Procedure May Include Repairing Nearby Tissue. |
| 46258-CPT | Moderate | Remove In Ex Hem Grp W Fistu, Hemorrhoidectomy Internal And External Single Column Group With Fistulectomy Including Fissurectomy When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46255. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46255 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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