Summary & Overview
CPT 46947: Stapled Hemorrhoidopexy (Hemorrhoidectomy with Repositioning)
CPT code 46947 represents a surgical hemorrhoid procedure that removes enlarged hemorrhoidal tissue, repositions residual tissue to its normal location, and secures it with staples. Nationally, this code captures a definitive operative approach for symptomatic internal hemorrhoids often considered when conservative therapies fail. The procedure has implications for surgical utilization, facility resource planning, and coding accuracy because it typically occurs in ambulatory surgical centers or hospital operating rooms under colorectal or general surgery service lines.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise orientation to clinical intent and service context, followed by benchmarking and reimbursement context where available. The publication outlines typical settings of care, billing considerations tied to procedural coding, and high-level policy or coverage themes that affect nationwide adoption and coding practice.
The report is intended to help coding professionals, surgical administrators, and payers understand where CPT code 46947 fits in clinical pathways, the operational sites where it is most often delivered, and the types of payer policies that commonly affect prior authorization, coverage, and payment. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 46947 describes a surgical procedure in which a provider removes abnormally enlarged hemorrhoidal tissue, repositions the remaining hemorrhoidal tissue to its normal anatomical position, and staples the tissue in place. This procedure is a form of hemorrhoid rectification that combines tissue excision with stapling to restore normal anatomy.
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Service type: Surgical hemorrhoidectomy with stapling (procedural, operative)
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Typical site of service: Ambulatory surgical center or hospital operating room for colorectal or general surgery procedures
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.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default or unspecified modifier | Rarely used; not typically appended when a specific modifier applies |