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See a sample rate comparisonCPT 46261 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 SG - Scene to Hospital ESRD facility 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46261 |
| Medicaid Fee Schedule | View Medicaid rates for 46261 |
National average reimbursement for CPT 46261 by major payers:
$660.34
$689.42
$710.24
$853.30
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CPT 46261
5 of 25 sample ratesHigher to lower in this preview
Trident Ambulatory Surgery Center, L.P.
Trident Ambulatory Surgery Center Lp
$6,649.00Published rateLake Endoscopy Center, LLC
Lake Endoscopy Center LLC
$2,307.00Published rateWoodland Surgery Center LLC
Woodland Surgery Center, LLC
$1,319.00Published rateVisionary Surgery Center Of Nevada, LLC
Visionary Surgery Center Of Nevada LLC
$1,045.00Published rateSurgical Center Of Burlington County, Inc
Surgical Center Of Burlington County Inc
$697.00Published rate
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See a sample payer proposalCPT 46261 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46261 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 46261 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 |
|---|---|---|
| 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 |
| 46261-CPT | Moderate | Hemorrhoid Surgery, Surgery To Remove One Or More Internal Or External Hemorrhoids. The Procedure May Include Repairing Nearby Tissue. |
| 46262-CPT | Moderate | Remove In Ex Hem Grps W Fist, Hemorrhoidectomy Internal And External 2 Or More Columns Groups 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 46261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46261 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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