How much does Medicare pay for CPT 46930?

Medicare allowed an average of $191.90 per service and paid $145.55 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $698.01, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 46930?

Destruction of internal hemorrhoids using heat. It was billed 3,138 times to 1,962 Medicare beneficiaries by 68 providers in 2024.

Does 46930 pay differently in an office than a hospital?

Yes. The allowed amount averaged $214.52 in an office setting and $107.62 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 46930 most?

Colorectal Surgery (Proctology), with 926 services from 13 clinicians. Next are General Surgery, Gastroenterology, Ambulatory Surgical Center.

CPT 46930

Destruction of internal hemorrhoids using heat

$191.90Medicare-allowed amount per service, averaged across 3,138 services

Providers submitted

$698.01

Asking price, not received

Medicare allowed

$191.90

The fee schedule figure

Medicare paid

$145.55

Balance is patient coinsurance

Providers submitted an average of $698.01 for this code and Medicare allowed $191.90 — 3.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $145.55 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $214.52
Hospital / facility: $107.62

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,474 services were billed in an office setting and 664 in a facility.

Services: 3,138
Beneficiaries: 1,962
Providers billing it: 68
Total allowed: $602,182

What Medicare pays for CPT 46930

Across 3,138 services billed by 68 providers to 1,962 beneficiaries, Medicare allowed an average of $191.90 per service. That is 1.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 46930

Specialty	Services	Beneficiaries	Avg allowed	Providers
Colorectal Surgery (Proctology)	926	593	$218.84	13
General Surgery	568	295	$207.11	13
Gastroenterology	487	410	$156.67	21
Ambulatory Surgical Center	276	271	$112.83	12
Nurse Practitioner	208	135	$195.97	2
Obstetrics & Gynecology	199	76	$193.85	1
Internal Medicine	196	69	$191.27	2
Family Practice	143	68	$205.14	2
Physical Therapist in Private Practice	135	45	$209.57	2

46930 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	677	$221.04	$148.21	8
Maine	375	$223.33	$162.68	1
Ohio	370	$155.47	$127.03	9
Florida	289	$169.36	$123.70	8
Kansas	281	$187.35	$157.79	3
New York	220	$217.64	$151.15	6
North Dakota	135	$209.57	$154.60	2
New Jersey	103	$150.24	$101.30	6
Maryland	99	$107.04	$81.67	5
Missouri	78	$205.75	$160.35	1
Pennsylvania	74	$213.50	$157.03	2
Arizona	65	$204.41	$165.71	1
Indiana	65	$196.84	$143.14	2
South Carolina	63	$174.96	$145.72	2
New Hampshire	54	$226.08	$161.96	1
Tennessee	50	$192.28	$161.38	1
Kentucky	18	$69.82	$60.37	1
Arkansas	16	$186.42	$155.45	1
Alaska	16	$249.01	$159.34	1
Texas	16	$70.40	$67.73	1
Illinois	15	$76.77	$60.63	1
West Virginia	13	$81.30	$69.29	1
Colorado	12	$136.61	$95.00	1
Georgia	12	$93.33	$71.19	1
Nebraska	11	$136.03	$101.21	1
South Dakota	11	$75.68	$61.50	1

Related codes

46946Tying of multiple internal hemorrhoid groups$866.41

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.