2025 CPT code 46261
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Digestive System - Hemorrhoidectomy Surgery Feed
Excision of two or more internal and external hemorrhoid columns or groups, along with a fissurectomy (removal of an anal fissure).
Modifiers may apply depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural service, etc.).
Medical necessity for a 46261 procedure is established by the presence of symptomatic internal and external hemorrhoids causing significant pain, bleeding, or prolapse, and a symptomatic anal fissure not responding to conservative management. Documentation should support the need for surgical intervention.
The surgeon's responsibilities include preparing the patient, administering anesthesia, locating and accessing the hemorrhoids and fissure, performing the excisions, irrigating the surgical sites, and closing incisions (or allowing them to heal naturally).
In simple words: This surgery removes two or more piles (hemorrhoids) inside and outside the anus, and also repairs a small tear in the anus.
This procedure involves the surgical removal of two or more columns or groups of both internal and external hemorrhoids.Additionally, it includes the excision of an anal fissure (a tear in the lining of the anus). The surgeon accesses the hemorrhoids by retracting the anal canal, incises the mucosa around the hemorrhoid columns, separates them from surrounding tissues, and removes them. The fissure is then incised and excised.The operative sites are irrigated with antibiotics, and incisions are closed with sutures or left open to heal naturally.
Example 1: A 55-year-old male presents with bleeding, pain, and discomfort from two groups of internal and external hemorrhoids, and a chronic anal fissure.The surgeon performs a 46261 procedure., A 40-year-old female with significant pain, bleeding, and prolapse from three groups of internal and external hemorrhoids, and an anal fissure undergoes a 46261 procedure., A 60-year-old male patient with a history of constipation experiences pain and bleeding from two groups of internal and external hemorrhoids and an anal fissure. A 46261 procedure is carried out.
Complete history and physical examination, including documentation of the number of hemorrhoid columns/groups, presence of an anal fissure, and surgical findings. Operative report detailing the procedure, including incision, excision, irrigation, and closure techniques. Anesthesia record.Postoperative care notes. Pathology report (if applicable).
** Careful documentation is required to differentiate this code from other hemorrhoidectomy codes (e.g., those involving only external hemorrhoids, or those without a fissurectomy).
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- Payment Status: Active
- Specialties:General Surgery, Colorectal Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center