CPT 46930 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 46930: Destruction of Internal Hemorrhoids by Thermal Techniques

CPT code 46930 represents the destruction of internal hemorrhoids by thermal techniques such as infrared coagulation, cauterization, or radiofrequency. This minimally invasive anorectal procedure is widely used to treat symptomatic internal hemorrhoids and is an important ambulatory surgical code for colorectal and general surgery practices nationwide. Its prevalence matters because it affects procedure coding, outpatient surgical volumes, and payer coverage decisions across commercial and government plans.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, expected sites of service (office, ambulatory surgery center, hospital outpatient), and typical billing considerations for procedures that use thermal hemorrhoid destruction. The publication summarizes common modifiers associated with ambulatory surgical services and notes where data was not available.

This article provides benchmarks and policy context relevant to coding accuracy and payer coverage trends, plus practical information on clinical indication alignment and documentation needs for correct claim submission. Data not available in the input are explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare46930CPThemorrhoid-treatmentanorectal-proceduresinfrared-coagulationambulatory-surgerythermal-ablationoutpatient-procedures

Billing Code Overview

CPT code 46930 describes the destruction of internal hemorrhoids using thermal techniques such as infrared coagulation, cauterization, or radiofrequency. This procedure is a minimally invasive anorectal treatment focused on obliterating hemorrhoidal tissue to reduce bleeding and prolapse.

Service type: Office-based or ambulatory surgical procedure involving anorectal therapeutic intervention
Typical site of service: Ambulatory surgery center, hospital outpatient department, or physician office with appropriate minor procedure capability

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient presents to an outpatient colorectal clinic with symptomatic internal hemorrhoids causing intermittent painless rectal bleeding and prolapse with discomfort during bowel movements. After history, physical exam including anoscopy confirms grade I–III internal hemorrhoids. Conservative therapy has failed (high-fiber diet, topical agents, stool softeners). The provider schedules an office-based procedural visit to perform destruction of internal hemorrhoidal tissue using infrared coagulation (a common thermal technique). The typical workflow: patient registration and targeted history, focused exam and anoscopy in procedure room, informed consent for 46930, local anesthesia or topical preparation as needed, application of infrared coagulator (or alternative thermal device such as radiofrequency or cautery) to each hemorrhoidal cushion until coagulation achieved, brief post-procedure observation, discharge with wound care and activity instructions, and a follow-up visit if bleeding or pain persists. Typical site of service is an ambulatory clinic/procedure room or outpatient surgical center. Typical patient scenario includes adults with symptomatic internal hemorrhoids refractory to conservative measures. Common payors encountered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`25`	Data not available in the input.	Data not available in the input.

CPT 46910: Destruction of Anal Lesion by Thermal Cautery

CPT-46900-CHEMICAL-DESTRUCTION-ANAL-LESION

CPT 46900: Chemical Destruction of Anal Lesion

CPT-46946-EXCISION-MULTIPLE-HEMORRHOIDS-NON-RUBBER-BAND-TECHNIQUES

CPT 46946: Excision of Two or More Hemorrhoids (Non-Rubber Band)

CPT-46948-ULTRASOUND-GUIDED-HEMORRHOIDAL-DEVASCULARIZATION-MUCOPEXY

CPT 46948: Ultrasound-Guided Hemorrhoidal Devascularization with Mucopexy

CPT-46916-ANAL-LESION-DESTRUCTION-CRYOTHERAPY

CPT 46916: Destruction of Anal Lesion Using Cryotherapy

CPT-46947-HEMORRHOIDECTOMY-STAPLED-HEMORRHOIDOPEXY

CPT 46947: Stapled Hemorrhoidopexy (Hemorrhoidectomy with Repositioning)

CPT-46940-ANAL-FISSURE-OTOMY-AND-SPHINCTER-DILATION

CPT 46940: Anal Fissure Removal with Anal Sphincter Dilation

CPT-46922-ANAL-LESION-DESTRUCTION-EXCISION

CPT 46922: Excision or Destruction of Anal Lesion

CPT-46945-HEMORRHOIDECTOMY-SINGLE-HEMORRHOID-EXCISION-NON-RUBBER-BAND

CPT 46945: Hemorrhoidectomy for Single Hemorrhoid or Group

CPT-46917-ANAL-LESION-DESTRUCTION-LASER

CPT 46917: Laser Destruction of Anal Lesion

Showing 1–10 of 12

Modifier	Description	When to Use
`11`	Data not available in the input.	Data not available in the input.

Modifier	Description	When to Use
`22`	Increased procedural services.	Use when the work required to perform `46930` is substantially greater than typically required.

Modifier	Description	When to Use
`23`	Unusual anesthesia.	Use when general anesthesia or neuraxial anesthesia is required for `46930` because of unusual circumstances.

Modifier	Description	When to Use
`26`	Professional component.	Use when billing only the physician professional component separate from technical facility services.

Modifier	Description	When to Use
`52`	Reduced services.	Use if the procedure is started but discontinued and a reduced charge is appropriate.

Modifier	Description	When to Use
`53`	Discontinued procedure.	Use when `46930` is terminated prior to completion for patient safety.

Modifier	Description	When to Use
`59`	Distinct procedural service.	Use when `46930` is performed on a separate anatomic site or distinct session from another procedure on the same day.

Modifier	Description	When to Use
`62`	Two surgeons.	Use when two surgeons work together as primary surgeons during a single complex anorectal procedure that includes `46930`.

Modifier	Description	When to Use
`78`	Return to the operating room for related procedure during the postoperative period.	Use when a related reoperation for complications of `46930` occurs during the global period.

Modifier	Description	When to Use
`79`	Unrelated procedure or service by the same physician during postoperative period.	Use when an unrelated procedure is performed during the global period of `46930`.

Modifier	Description	When to Use
`52`	Data not available in the input.	Data not available in the input.

Taxonomy Code	Specialty	Notes
`2080S0106X`	Colon and Rectal Surgery	Common specialty performing hemorrhoid interventions including `46930`.
`207P00000X`	Proctology (General Surgery subspecialty)	Providers focused on anorectal procedures in outpatient settings.
`207L00000X`	Gastroenterology	Gastroenterologists may perform office-based hemorrhoid procedures such as infrared coagulation.
`207N00000X`	Family Medicine	Family physicians with office procedural skills may perform `46930` in outpatient clinic.
`207RC0000X`	General Surgery	General surgeons perform hemorrhoid treatments in ambulatory surgical centers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K64.8`	Other hemorrhoids.	Captures internal hemorrhoids not specified elsewhere; commonly used with `46930`.
`K64.0`	First-degree hemorrhoids.	Early internal hemorrhoids treated with office-based thermal coagulation like `46930`.
`K64.1`	Second-degree hemorrhoids.	Hemorrhoids that prolapse with defecation and reduce spontaneously; commonly treated with `46930`.
`K64.2`	Third-degree hemorrhoids.	Hemorrhoids requiring manual reduction; `46930` may be used in selected third-degree cases.
`K62.5`	Hemorrhage of anus and rectum.	Symptom code used when bleeding is a primary complaint prompting hemorrhoid therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`45330`	Flexible sigmoidoscopy, diagnostic; with biopsy, single or multiple.	Performed prior to `46930` when evaluation of distal colon/rectum is needed or to rule out other sources of bleeding.
`45380`	Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure).	Performed when broader colonic evaluation is indicated for lower GI bleeding before hemorrhoid-directed therapy such as `46930`.
`46221`	Hemorrhoidectomy, external, with thrombectomy; single or multiple.	Surgical alternative for external hemorrhoids or more advanced disease when `46930` is not appropriate.
`46970`	Destruction of internal hemorrhoids, any method, by ligation (e.g., rubber band).	An alternative office-based treatment to `46930`; may be performed instead of or in addition to thermal techniques.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedure.	Used to report additional disposable supplies or devices used during an office procedure like `46930`.

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