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Procedure price report · Hemorrhoid procedures

Tying off internal hemorrhoids, two or more groups, no band

CPT 46946the billing code this page is about

Surgery that ties off two or more columns or groups of internal hemorrhoids using a method other than rubber band ligation; one charge covers all groups treated.

Hospitals typically charge $1,840 cash for this outpatient procedure — the median across 760 hospitals that filed a usable cash price; the average of the middle 60% is $1,990. Most fall between $548 and $4,325 (20th–80th percentile).

Hospitals
760
States
50
Filings dated
Mar 2023 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 760 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$395$624$1,840$3,767$6,759

The most expensive tenth of hospitals charges at least 17× what the cheapest tenth charges ($395 vs $6,759).

How the prices are spread

$305 – $435: 71 hospitals$305$435 – $619: 73 hospitals$619 – $881: 80 hospitals$619$881 – $1,254: 83 hospitals$1,254 – $1,785: 32 hospitals$1,254$1,785 – $2,541: 76 hospitals$2,541 – $3,618: 101 hospitals$2,541$3,618 – $5,151: 91 hospitals$5,151 – $7,333: 52 hospitals$5,151$7,333 – $10,439: 28 hospitals$7,333median $1,840price bands are equal on a log scale
Hospitals per price band (687 of 760 — the bands cover the 5th to 95th percentile)
FromToHospitals
$305$43571
$435$61973
$619$88180
$881$1,25483
$1,254$1,78532
$1,785$2,54176
$2,541$3,618101
$3,618$5,15191
$5,151$7,33352
$7,333$10,43928

Against Medicare

Medicare pays (OPPS 2026, national rate)$2,836
Median cash price$1,840
Cash as a multiple of Medicare0.65×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $1,840.

Alaska: 5 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 5 hospitals filed a usable price — fewer than 10, so no figureMEVermont: median $539 across 10 hospitalsVT$539New Hampshire: 5 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $748 across 18 hospitalsWA$748Idaho: median $2,300 across 10 hospitalsID$2,300Montana: 5 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 4 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $932 across 32 hospitalsMN$932Illinois: median $956 across 33 hospitalsIL$956Wisconsin: median $1,054 across 45 hospitalsWI$1,054Michigan: median $405 across 35 hospitalsMI$405New York: median $1,120 across 35 hospitalsNY$1,120Massachusetts: 6 hospitals filed a usable price — fewer than 10, so no figureMAOregon: median $1,069 across 24 hospitalsOR$1,069Nevada: 5 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 4 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 8 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $932 across 30 hospitalsIA$932Indiana: median $369 across 14 hospitalsIN$369Ohio: median $3,275 across 31 hospitalsOH$3,275Pennsylvania: median $2,837 across 41 hospitalsPA$2,837New Jersey: median $3,659 across 33 hospitalsNJ$3,659Connecticut: 2 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 1 hospital filed a usable price — fewer than 10, so no figureRICalifornia: median $4,999 across 59 hospitalsCA$4,999Utah: 4 hospitals filed a usable price — fewer than 10, so no figureUTColorado: 8 hospitals filed a usable price — fewer than 10, so no figureCONebraska: median $782 across 10 hospitalsNE$782Missouri: median $547 across 14 hospitalsMO$547Kentucky: median $385 across 10 hospitalsKY$385West Virginia: median $3,191 across 17 hospitalsWV$3,191Virginia: median $3,402 across 12 hospitalsVA$3,402Maryland: 3 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 1 hospital filed a usable price — fewer than 10, so no figureDEArizona: 6 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 8 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $499 across 17 hospitalsKS$499Arkansas: 4 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $510 across 10 hospitalsTN$510North Carolina: 9 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: 7 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: median $622 across 14 hospitalsOK$622Louisiana: median $1,546 across 11 hospitalsLA$1,546Mississippi: 3 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 7 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $2,235 across 21 hospitalsGA$2,235Hawaii: 5 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $1,727 across 40 hospitalsTX$1,727Florida: median $4,422 across 19 hospitalsFL$4,422
Cash price by state, most expensive first. National median $1,840. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
California CA59$4,999+172%$2,008 – $6,759
Florida FL19$4,422+140%$4,013 – $4,568
New Jersey NJ33$3,659+99%$3,038 – $5,419
Virginia VA12$3,402+85%$257 – $9,657
Ohio OH31$3,275+78%$595 – $4,583
West Virginia WV17$3,191+73%$419 – $3,431
Pennsylvania PA41$2,837+54%$246 – $3,687
Idaho ID10$2,300+25%$856 – $7,189
Georgia GA21$2,235+21%$2,235 – $4,862
Texas TX40$1,727−6%$1,727 – $2,774
Louisiana LA11$1,546−16%$1,233 – $4,451
New York NY35$1,120−39%$584 – $3,245
Oregon OR24$1,069−42%$703 – $3,176
Wisconsin WI45$1,054−43%$548 – $1,840
Illinois IL33$956−48%$671 – $10,750
Iowa IA30$932−49%$576 – $932
Minnesota MN32$932−49%$720 – $2,502
Nebraska NE10$782−57%$502 – $925
Washington WA18$748−59%$486 – $4,137
Oklahoma OK14$622−66%$622 – $5,591
Missouri MO14$547−70%$413 – $5,950
Vermont VT10$539−71%$342 – $984
Tennessee TN10$510−72%$282 – $3,470
Kansas KS17$499−73%$380 – $950
Michigan MI35$405−78%$404 – $3,817
Kentucky KY10$385−79%$302 – $11,012
Indiana IN14$369−80%$305 – $11,012
North Carolina NC9not enough hospitals filed a usable price
Colorado CO8not enough hospitals filed a usable price
New Mexico NM8not enough hospitals filed a usable price
South Dakota SD8not enough hospitals filed a usable price
Alabama AL7not enough hospitals filed a usable price
South Carolina SC7not enough hospitals filed a usable price
Arizona AZ6not enough hospitals filed a usable price
Massachusetts MA6not enough hospitals filed a usable price
Alaska AK5not enough hospitals filed a usable price
Hawaii HI5not enough hospitals filed a usable price
Maine ME5not enough hospitals filed a usable price
Montana MT5not enough hospitals filed a usable price
New Hampshire NH5not enough hospitals filed a usable price
Nevada NV5not enough hospitals filed a usable price
Arkansas AR4not enough hospitals filed a usable price
North Dakota ND4not enough hospitals filed a usable price
Utah UT4not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Maryland MD3not enough hospitals filed a usable price
Mississippi MS3not enough hospitals filed a usable price
Connecticut CT2not enough hospitals filed a usable price
Delaware DE1not enough hospitals filed a usable price
Rhode Island RI1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $1,840.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care555$2,652$622 – $4,862
Children’s8fewer than 20 hospitals
Critical access195$794$424 – $1,840
Ownership
For-profit69$2,774$656 – $6,673
Government140$920$485 – $3,406
Non-profit549$1,840$556 – $4,422
System affiliation
Part of a system606$2,235$590 – $4,554
Independent154$853$477 – $3,105

Cash price vs list price

Median list price (chargemaster)$2,407
Median cash price$1,840
Cash as a share of list, median hospital62%

At the typical hospital, asking for the cash price cuts the list price by about 38%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

431 hospitals filed a usable inpatient cash price for this code. The median is $1,572 and the average of the middle 60% is $1,813; most fall between $510 and $4,316.

Cash price percentiles, inpatient, across 431 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$314$581$1,572$3,767$6,759

The most expensive tenth of hospitals charges at least 21× what the cheapest tenth charges ($314 vs $6,759).

Of the 479 hospitals that filed this code inpatient, 431 gave a usable cash price; 23 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 25 a list price only.

How complete is this

760 of the 3,956 hospitals with a price file in our corpus (19%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 836 hospitals that filed this code at all gave us
Usable cash price — counted760
Cash price carrying a plausibility flag — shown on the compare tool, excluded here46
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded1
An estimate rather than a filed cash price — excluded3
A list price only, no cash figure — excluded26
Hospitals that filed this code836

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Hemorrhoid procedures family.

Hospitals file this code under descriptions such as Int Hrhc by Ligation 2+ Hroid W/O Img Gdn.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Tying off internal hemorrhoids, two or more groups, no band (CPT 46946) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-46946-tying-off-internal-hemorrhoids-two-or-more-groups-no-band