46257 Remove in/ex hem group & fiss
Also known as: hem removal with fissure, hemorrhoidectomy with fissurectomy, combined treatment
Surgical removal of internal and external hemorrhoid groups with concurrent anal fissure treatment. Addresses both hemorrhoid disease and concurrent fissure pathology.
In Plain Language
removing hemorrhoids and fixing a tear in the anal canal; treatment of hemorrhoids and fissure together
Clinical Context
Performed when hemorrhoids and anal fissures coexist, often with fissurectomy or sphincterotomy included. Common presentation in chronic hemorrhoid disease.
RVU Breakdown
| Work RVU | 5.62 |
| Total RVU | 5.62 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 5.62, this code ranks in the 38th percentile among Surgery codes — 1.4x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 46257?
CPT 46257 (Remove in/ex hem group & fiss) is a Surgery code. Surgical removal of internal and external hemorrhoid groups with concurrent anal fissure treatment. Addresses both hemorrhoid disease and concurrent fissure pathology.
What is the wRVU value for CPT 46257?
The work RVU for CPT 46257 is 5.62. This code is primarily used by Colorectal Surgery, General Surgery. It has a 90-day global period.
When is CPT 46257 used?
Performed when hemorrhoids and anal fissures coexist, often with fissurectomy or sphincterotomy included. Common presentation in chronic hemorrhoid disease.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.