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2025 CPT code 46250

Excision of two or more external hemorrhoid columns or groups.

Use 46250 for the excision of two or more external hemorrhoid columns/groups. For a single external hemorrhoid/group, use 46999.

Modifiers such as 22 (Increased Procedural Services), 51 (Multiple Procedures), 52 (Reduced Services), 53 (Discontinued Procedure), etc., may be applicable depending on the circumstances.

Medical necessity should be established by documenting the severity of symptoms, failure of conservative treatment, and the impact on the patient's quality of life.

The physician is responsible for patient preparation, anesthesia, locating and excising the hemorrhoids, controlling bleeding, irrigation, and wound closure.

IMPORTANT:For single external hemorrhoid excision, use 46999. For combined internal and external hemorrhoidectomy, see 46255-46262.For other hemorrhoid procedures, see 46083, 46221, 46945, 46946, 46320, 46500, 46930, 46999, 46948, 46947. Do not report with 46600, 46020-46947, 0184T in the same session.

In simple words: This procedure removes two or more external hemorrhoids. The area is numbed, and the hemorrhoids are cut out.The doctor then stops any bleeding and may stitch the area closed.

This procedure involves the surgical removal of two or more external hemorrhoids or hemorrhoid groups.The provider prepares the patient, administers anesthesia, and locates the hemorrhoids. An incision is made around each hemorrhoid column, and the hemorrhoids are separated from surrounding tissues and removed. Bleeding is controlled, the area is irrigated, and the incisions are closed with sutures or left open to heal.

Example 1: A patient presents with two large, painful external hemorrhoids that have not responded to conservative treatment.46250 is used for the surgical excision., A patient has three thrombosed external hemorrhoids causing significant discomfort.After discussing options, the physician performs a hemorrhoidectomy using 46250., During an anorectal exam, a physician identifies multiple external hemorrhoids. The patient elects to have them surgically removed, and 46250 is billed.

Documentation should include the number and location of hemorrhoids, the surgical technique used, any complications, and post-operative instructions.

** Ensure accurate documentation of the procedure performed to support the use of this code. Check NCCI edits for code pairing restrictions. Review payer-specific guidelines for coverage and reimbursement.

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