Summary & Overview
CPT 46945: Hemorrhoidectomy for Single Hemorrhoid or Group
CPT code 46945 represents a surgical hemorrhoidectomy performed with techniques other than rubber band ligation to remove a single hemorrhoid or hemorrhoid group. This code captures a common definitive anorectal procedure for patients with symptomatic hemorrhoids that are not amenable to office-based or nonoperative treatments. Nationally, accurate reporting of 46945 affects surgical case mix, provider reimbursement, and utilization measurement for ambulatory and outpatient surgical services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical context for 46945, typical sites of service, and how the code is used in procedural reporting. The publication provides benchmarks and utilization context where available, notes common billing modifiers, and summarizes policy and coverage considerations relevant to payers and facility billing. Clinical details explain when a hemorrhoidectomy would be selected over nonoperative approaches and the implications for coding when imaging guidance is not used.
This summary serves clinicians, coders, and policy analysts seeking concise, national-level information about CPT code 46945, its clinical role, and the billing context for ambulatory surgical and outpatient settings.
Billing Code Overview
CPT code 46945 describes a hemorrhoidectomy performed using techniques other than a rubber band technique to remove a single hemorrhoid or hemorrhoid group. The procedure involves surgical excision of a small swollen vessel in the rectum or anus when noninvasive measures are insufficient.
Service Type: Surgical — anorectal procedure
Typical Site of Service: Ambulatory surgery center or hospital outpatient department; may also be performed in an operating room
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old adult presenting to an outpatient ambulatory surgery center or hospital minor procedure room with symptomatic external or internal hemorrhoid(s) refractory to conservative measures (dietary fiber, stool softeners, topical therapies, and office-based rubber band ligation). The patient reports persistent bleeding, pain, prolapse, or thrombosis of a single hemorrhoid or a localized group. After history and focused anorectal examination, the surgeon obtains informed consent for hemorrhoidectomy under local, regional, or monitored anesthesia care. The procedure consists of excision of the targeted hemorrhoid(s) using surgical techniques other than rubber band ligation (for example, excisional hemorrhoidectomy with scalpel, electrocautery, or stapled excision when stapling is not used for imaging guidance). The typical workflow includes preoperative assessment, anesthesia administration, operative excision without image guidance, hemostasis, brief recovery, and discharge with wound care and activity instructions. Typical sites of service are ambulatory surgery centers and hospital outpatient departments, with occasional performance in office procedure rooms equipped for minor surgical procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, uncomplicated surgical procedure | Use when the service represents the primary, scheduled operation performed without unusual circumstances. |