CPT 46221 Surgery - Digestive

How Much Does Ligation of Hemorrhoid(s) Cost?

Also known as: Ligation of hemorrhoid(s) (CPT 46221)

Treatment of hemorrhoids using rubber band ligation (placing small rubber bands around hemorrhoids to cut off blood flow).

The total estimated cost of Ligation of Hemorrhoid(s) (CPT 46221) is $662 to $1,241, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $197.

Total Estimated Cost of Care

$662 — $1,241

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$197
Hospital Facility Fee
$591
Anesthesia (est.)
$39
Important: The physician fee of $197 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$197
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$326
Non-facility setting

Patient Guide: Ligation of Hemorrhoid(s)

What you need to know before your appointment

What to Expect

During an office visit or colonoscopy, the doctor places a tiny rubber band at the base of each internal hemorrhoid. This cuts off blood flow, causing the hemorrhoid to shrink and fall off in 1-2 weeks.

How Long Does It Take?

5-10 minutes

Common Reasons Doctors Order This

Internal hemorrhoids causing bleeding, prolapsing hemorrhoids, hemorrhoids not responding to conservative treatment

How to Prepare

An enema may be needed before. You may feel pressure or cramping briefly. Avoid straining after the procedure. Eat high-fiber foods and drink plenty of water.

Procedures Commonly Done Together

These procedures are frequently performed alongside Ligation of hemorrhoid(s)

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How to Reduce Your Cost for Ligation of hemorrhoid(s)

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($326) differs from the facility rate ($197). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.30
Work RVU
3.24
Practice Expense RVU
0.36
Malpractice RVU
9.75
Total RVU

Payment = Total RVU (9.75) x CF ($33.40) = $326

Frequently Asked Questions

How much does Ligation of hemorrhoid(s) cost?

The Medicare facility rate for Ligation of hemorrhoid(s) is $197. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Ligation of hemorrhoid(s) cost without insurance?

Without insurance, the cost of Ligation of hemorrhoid(s) can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Ligation of hemorrhoid(s)?

Most commercial health insurance plans and Medicare cover Ligation of hemorrhoid(s) when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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