2025 CPT code 46257
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Digestive System - Hemorrhoidectomy Surgery Feed
Hemorrhoidectomy, internal and external, single column/group; with fissurectomy.
Modifiers may apply depending on circumstances such as multiple procedures (modifier 51), reduced services (modifier 52), or other relevant situations. Refer to the CPT guidelines for appropriate modifier usage.
Medical necessity for this procedure is established when the patient experiences significant symptoms such as pain, bleeding, or prolapse of hemorrhoids, which significantly impair their quality of life and have not responded to conservative management. The presence of an anal fissure further supports the medical necessity.
The surgeon performs the excision of the hemorrhoids and the fissure. This includes locating the hemorrhoids and fissure, making incisions, dissecting the lesions, removing them, and closing the incisions.
In simple words: This surgery removes a cluster of internal and external hemorrhoids (swollen veins in and around the anus) and a fissure (a tear in the anal lining). The doctor makes cuts to reach the hemorrhoids and fissure, removes them, and closes the cuts with stitches or lets them heal on their own.This helps relieve pain, bleeding, and other problems caused by the hemorrhoids and fissure.
This procedure involves the surgical excision of a single column or group of both internal and external hemorrhoids, along with the excision of an anal fissure (a tear or ulcer in the lining of the anus).The surgeon makes incisions to access the hemorrhoids, dissects them from surrounding tissues, and removes them. The fissure is similarly incised and excised.The incisions are then closed with sutures or left open to heal naturally. This procedure addresses the presence of hemorrhoids causing significant discomfort, bleeding, or other symptoms, and also treats the associated fissure.
Example 1: A 45-year-old patient presents with a single cluster of internal and external hemorrhoids and a painful anal fissure. The surgeon performs a hemorrhoidectomy and fissurectomy using code 46257., A 60-year-old patient with chronic constipation and a history of straining during bowel movements presents with a single group of internal and external hemorrhoids and an anal fissure causing significant pain and bleeding.A hemorrhoidectomy and fissurectomy (46257) is performed., A 30-year-old pregnant patient experiences painful hemorrhoids and an anal fissure in the later stages of pregnancy.After delivery, she undergoes a hemorrhoidectomy and fissurectomy (46257) to address these issues.
Preoperative evaluation and documentation of the hemorrhoids and fissure, including size, location, and severity of symptoms. Intraoperative notes detailing the surgical technique, excision of both hemorrhoids and fissure, and closure of the incisions. Postoperative notes including any complications and patient recovery.
** Always confirm the number of hemorrhoid columns/groups to select the correct code (46257 vs. 46261). Accurate documentation is crucial for proper reimbursement.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: Data not available in source.RVUs vary based on geographic location, facility type, and other factors. Consult the specific payer's fee schedule.
- Global Days : Data not available in source. Global surgical package days vary by payer and may include pre- and postoperative care.
- Payment Status: Active
- Modifier TC rule: Not applicable. This code does not involve distinct professional and technical components.
- Fee Schedule : Data not available in source.Fee schedules vary by payer and geographic location. Consult the relevant fee schedule for the specific time period.
- Specialties:General Surgery, Colorectal Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)