# CPT 46221: Hemorrhoidectomy, by rubber band ligation

Medicare CPT 46221 pays $325.66 in a non-facility setting and $197.07 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $286.44 in Arkansas to $374.06 in Alaska, a 31% spread.

Web page: https://www.med-reveal.com/rates/46221-cpt-fee-schedule
Section: Surgery and Procedures

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $325.66 |
| National facility | $197.07 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $374.06 | $237.11 |
| District of Columbia | $373.32 | $221.84 |
| California | $366.31 | $214.15 |
| New York | $361.00 | $217.54 |
| New Jersey | $360.45 | $215.65 |
| Washington | $358.70 | $212.10 |
| Massachusetts | $355.22 | $210.74 |
| Hawaii | $353.04 | $206.83 |
| Connecticut | $347.95 | $209.46 |
| Colorado | $339.10 | $202.28 |
| Florida | $337.83 | $208.81 |
| Maryland | $337.65 | $203.60 |
| Oregon | $335.62 | $200.15 |
| New Hampshire | $333.87 | $200.00 |
| Rhode Island | $333.63 | $200.80 |
| Illinois | $328.89 | $204.64 |
| Puerto Rico | $328.08 | $198.08 |
| Virgin Islands | $328.08 | $198.08 |
| Montana | $325.63 | $197.04 |
| Minnesota | $324.06 | $191.74 |
| Nevada | $323.89 | $195.17 |
| Wyoming | $322.53 | $193.94 |
| Pennsylvania | $322.33 | $196.37 |
| Delaware | $321.99 | $194.94 |
| Texas | $321.56 | $194.95 |
| North Dakota | $318.52 | $189.92 |
| Virginia | $318.10 | $191.69 |
| South Dakota | $317.67 | $189.08 |
| Vermont | $317.35 | $190.04 |
| Georgia | $317.25 | $194.57 |
| Arizona | $316.59 | $191.98 |
| Michigan | $316.12 | $195.37 |
| Maine | $310.63 | $187.76 |
| Utah | $310.22 | $189.35 |
| New Mexico | $308.42 | $190.50 |
| Wisconsin | $307.39 | $184.20 |
| Missouri | $305.98 | $187.97 |
| South Carolina | $305.86 | $187.04 |
| Louisiana | $305.62 | $188.22 |
| North Carolina | $305.45 | $185.47 |
| Ohio | $305.15 | $187.75 |
| Indiana | $302.19 | $182.98 |
| Idaho | $300.38 | $182.07 |
| Nebraska | $299.95 | $181.25 |
| West Virginia | $299.82 | $188.07 |
| Tennessee | $298.54 | $181.65 |
| Kentucky | $298.35 | $184.03 |
| Iowa | $298.28 | $180.62 |
| Oklahoma | $297.64 | $182.80 |
| Kansas | $296.96 | $180.71 |
| Alabama | $290.84 | $178.32 |
| Mississippi | $289.60 | $178.88 |
| Arkansas | $286.44 | $175.97 |

## Related codes

- 40490: Biopsy of lip — https://www.med-reveal.com/rates/40490-cpt-fee-schedule
- 40650: Repair lip, vermilion only — https://www.med-reveal.com/rates/40650-cpt-fee-schedule
- 41010: Frenotomy, lingual — https://www.med-reveal.com/rates/41010-cpt-fee-schedule
- 41112: Excision of lesion of tongue — https://www.med-reveal.com/rates/41112-cpt-fee-schedule
- 41599: Unlisted procedure, tongue/floor of mouth — https://www.med-reveal.com/rates/41599-cpt-fee-schedule
- 42700: Incision and drainage of peritonsillar abscess — https://www.med-reveal.com/rates/42700-cpt-fee-schedule
- 42820: Tonsillectomy and adenoidectomy, under age 12 — https://www.med-reveal.com/rates/42820-cpt-fee-schedule
- 42821: Tonsillectomy and adenoidectomy, age 12 or over — https://www.med-reveal.com/rates/42821-cpt-fee-schedule

Commercial negotiated rates for 46221 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules