Summary & Overview
CPT 46250: Excision of Two or More External Hemorrhoids
CPT code 46250 denotes the surgical excision of two or more external hemorrhoids or hemorrhoid groups. This procedure represents a common anorectal surgical service for symptomatic external hemorrhoidal disease and is performed in outpatient surgical settings, ambulatory surgical centers, and, in some cases, office-based surgical suites. Nationally, it is a routinely billed minor surgical code with implications for facility site-of-service designation, anesthesia considerations, and post-operative care.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for the procedure, typical sites of service, common billing modifiers and coding considerations, and a summary of payer coverage patterns and benchmarks where available. The publication also outlines coding relationships and potential documentation needs to support medical necessity.
The content is intended for coding professionals, billing managers, clinicians involved in procedural care, and policy analysts seeking a clear, national-level summary of how CPT code 46250 is used, reimbursed, and administered across major commercial payers and Medicare.
Billing Code Overview
CPT code 46250 describes a surgical procedure in which the provider excises two or more external hemorrhoids or hemorrhoid groups. This is a minor surgical excision of external anorectal lesions.
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Service type: Surgical excision of external hemorrhoids
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Typical site of service: Ambulatory surgical center or hospital outpatient department, and procedures may also occur in office-based surgical settings depending on facility capabilities and provider preference.
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to a colorectal surgery clinic with a several-week history of painful, thrombosed external hemorrhoids, local bleeding with bowel movements, and difficulty with hygiene. Following outpatient evaluation including history, focused anorectal exam, and conservative therapy trials (topical agents, stool softeners, and sitz baths) with inadequate relief, the surgeon schedules an operative excision of multiple external hemorrhoids under monitored anesthesia care. Typical workflow: preoperative evaluation and consent in clinic; pre-op anesthesia assessment; procedure performed in an ambulatory surgery center or hospital outpatient department with the patient in the prone jackknife or lithotomy position; excision of two or more external hemorrhoids (hemostasis, inspection, dressing) with brief recovery and discharge with wound care and pain control instructions. Common payors for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when another separate procedure during the same session is distinct and not normally performed together. |
52 | Reduced services |