CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 46221 RVU and Medicare Payment (2026)
Ligation of hemorrhoid(s) — 2.3 work RVU, about $325.66 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.3
- PE RVU (non-facility)
- 7.09
- PE RVU (facility)
- 3.24
- MP RVU
- 0.36
- Office payment
- $325.66
- Facility payment
- $197.07
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 46221 in a non-facility setting with national GPCI: (2.3 + 7.09 + 0.36) × $33.4009 ≈ $325.66. The same code in a facility setting pays about $197.07 because facility PE RVU (3.24) replaces office PE RVU.
What changes by locality
GPCI moves 46221 non-facility payment from $286.44 to $433.2 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 46221?
2.3. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 46221 in 2026?
About $325.66 non-facility ($197.07 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (2.3) and malpractice RVU stay fixed; only practice expense changes (7.09 office vs 3.24 facility). That is the entire office-vs-facility payment gap.