46258 Remove in/ex hem group with fistu
Also known as: hem removal with fistula, hemorrhoidectomy with fistula repair, combined procedures
Surgical removal of internal and external hemorrhoid groups with concurrent anal fistula treatment. Comprehensive procedure addressing both hemorrhoids and fistula disease.
In Plain Language
removing hemorrhoids and fixing an anal fistula; treatment of hemorrhoids and fistula
Clinical Context
Performed when hemorrhoids and anal fistulas occur together, addressing both pathologies simultaneously. May include fistula-in-ano tract management.
RVU Breakdown
| Work RVU | 6.25 |
| Total RVU | 6.25 |
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 6.25, this code ranks in the 41st percentile among Surgery codes — 1.3x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 46258?
CPT 46258 (Remove in/ex hem group with fistu) is a Surgery code. Surgical removal of internal and external hemorrhoid groups with concurrent anal fistula treatment. Comprehensive procedure addressing both hemorrhoids and fistula disease.
What is the wRVU value for CPT 46258?
The work RVU for CPT 46258 is 6.25. This code is primarily used by Colorectal Surgery, General Surgery. It has a 90-day global period.
When is CPT 46258 used?
Performed when hemorrhoids and anal fistulas occur together, addressing both pathologies simultaneously. May include fistula-in-ano tract management.
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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.