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    v1.0.28
    OpenPayerBilling CodesDestruction Procedures on the AnusCPT cpt-46947-hemorrhoidectomy-stapled-hemorrhoidopexy
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    CPT 46947: Stapled Hemorrhoidopexy (Hemorrhoidectomy)

    Medicare pays $386 on average nationally for this procedure.

    CPT code 46947 describes a surgical procedure that removes enlarged hemorrhoidal tissue, repositions the remaining hemorrhoidal tissue to its normal anatomic position, and staples the tissue in place (stapled hemorrhoidopexy); this is a surgical anorectal procedure typically performed in an operating room or ambulatory surgical center under anesthesia and is categorized as a hemorrhoidectomy/stapled hemorrhoidopexy service.

    For related coverage guidance, see recent payer policy updates: Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults, Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in Adults, Site of Service Ambulatory Service Center (ASC) Select.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 45–65-year-old adult presenting with symptomatic, circumferential, prolapsing internal hemorrhoids that have failed conservative management (fiber, topical agents, office procedures). The patient reports rectal bleeding, mucous discharge, prolapse with bowel movements, and perianal discomfort. Prior to surgery, the colorectal surgeon evaluates comorbidities, reviews anticoagulation status, and performs a focused proctologic exam including anoscopy and flexible sigmoidoscopy as indicated to exclude other pathology. Preoperative optimization includes bowel preparation as per surgeon preference and anesthesia assessment.

    On the day of service, the patient is taken to an outpatient ambulatory surgery center or hospital operating room for a stapled hemorrhoidopexy (46947). Under general or regional anesthesia, the surgeon excises a circumferential ring of redundant mucosa and submucosa above the dentate line and repositions and staples the hemorrhoidal tissue into its normal anatomic position. Hemostasis is confirmed, and the patient is recovered in PACU with postoperative instructions for pain control, stool softeners, activity restrictions, and follow-up visit for wound assessment and suture/staple evaluation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    45378Colonoscopy, flexible, diagnostic, including collection of specimen by brushing or washing, when performed (separate procedure)Preoperative diagnostic evaluation to exclude distal colonic pathology prior to 46947 when indicated
    46045Incision and drainage, postoperative anorectal abscess; complicated (e.g., multiple foci)Management of perianal infection that may precede or complicate hemorrhoidal disease; may be performed before elective 46947 when infection is present
    46931Removal of impacted hemorrhoid, internal, by infrared coagulation, cryotherapy, or manual removal (alternative office therapies)Office-based or less invasive treatments that are often attempted prior to selecting stapled hemorrhoidopexy (46947)
    52204Cystourethroscopy, with ureteroscopy, not directly related but available for anorectal concurrent proceduresRarely relevant; listed when additional pelvic procedures occur in same operative session
    99152Moderate sedation services provided by the same physician performing diagnostic or therapeutic service that the sedation supports, initial 15 minutesMay be reported when moderate sedation/anesthesia is separately documented for parts of the procedure (payer rules apply)

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207VC0200XCritical Care Medicine (Obstetrics & Gynecology) PhysicianAn obstetrician/gynecologist, who specializes in critical care medicine diagnoses, treats and supports female patients with multiple organ dysfunction…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    207RR0500XRheumatology PhysicianAn internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, comm…
    207RH0003XHematology & Oncology PhysicianAn internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy t…
    332G00000XEye BankAn eye bank procures and distributes eyes for transplant, education and research. To promote patient safety, donated eyes and donor medial histories a…
    207UN0902XNuclear Imaging & Therapy PhysicianA nuclear medicine physician who specializes in nuclear imaging and therapy.

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E66.9Obesity, unspecified
    K52.9Noninfective gastroenteritis and colitis, unspecified
    K57.20Diverticulitis of large intestine with perforation and abscess without bleeding
    K57.30Diverticulosis of large intestine without perforation or abscess without bleeding
    K57.50Diverticulosis of both small and large intestine without perforation or abscess without bleeding
    K57.90Diverticulosis of intestine, part unspecified, without perforation or abscess without bleeding
    K58.0Irritable bowel syndrome with diarrhea
    K58.9Irritable bowel syndrome, unspecified
    K59.1Functional diarrhea
    K59.9Functional intestinal disorder, unspecified

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01
    Inpatient Surgical Site of ServiceProvidence Health Plan2026-07-01
    Removal of Implantable DevicesBlue Cross Blue Shield - Rhode Island2026-07-01

    Related Codes

    CPT-46900-CHEMICAL-DESTRUCTION-ANAL-LESION

    CPT 46900: Chemical Destruction of Anal Lesion

    CPT-46910-ANAL-LESION-DESTRUCTION-CAUTERY

    CPT 46910: Destruction of Anal Lesion by Electrocautery

    CPT-46916-ANAL-LESION-DESTRUCTION-CRYOTHERAPY

    CPT 46916: Destruction of Anal Lesion by Cryotherapy

    CPT-46917-ANAL-LESION-DESTRUCTION-LASER

    CPT 46917: Laser Destruction of Anal Lesion

    CPT-46922-ANAL-LESION-DESTRUCTION-EXCISION

    CPT 46922: Anal Lesion Destruction by Excision

    CPT-46924-EXTENSIVE-ANAL-LESION-DESTRUCTION

    CPT 46924: Extensive Destruction of Anal Lesion

    CPT-46930-INTERNAL-HEMORRHOID-THERMAL-DESTRUCTION

    CPT 46930: Destruction of Internal Hemorrhoids by Thermal Techniques

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

    CPT 46940: Anal Fissure Excision with Anal Sphincter Dilation

    CPT-46942-ANAL-FISSURE-DEBRIDEMENT-AND-SPHINCTER-DILATION-SUBSEQUENT

    CPT 46942: Anal Fissure Excision/Scraping with Sphincter Dilation, Subsequent

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

    CPT 46945: Hemorrhoidectomy, Single Hemorrhoid (Non-Band Technique)

    Showing 1–10 of 12

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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