Is hemorrhoid surgery covered by Medicare

Operative treatment of haemorrhoids involving third-degree or fourth-degree haemorrhoids, including excision of anal skin tags when performed, not being a service associated with a service to which item 32135 or 32233 applies (H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $388.75 Benefit: 75% = $291.60

Treatment of haemorrhoids or rectal prolapse, including rubber band ligation or sclerotherapy for, not being a service to which item 32139 applies 

Multiple Operation Rule

(Anaes.)

Fee: $71.40 Benefit: 75% = $53.55 85% = $60.70

Using this guide What's covered

Here you’ll find answers to many of your questions about haemorrhoid surgery (known as haemorrhoidectomy). Learn how it’s done, what it may cost, what your recovery may be like, and more.

To see how the surgery’s preformed, view our animation below.

For personal insights, see our patient experience videos in which HCF members talk frankly about their preparation, surgery and recovery.

Cost indicator

Discover the typical out-of-pocket costs HCF members can expect to pay for haemorrhoid surgery and learn how your choice of surgeon and hospital affect that cost.

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Learn about haemorrhoid surgery

This short animation explains how and why the haemorrhoid is removed.

What are haemorrhoids?

Haemorrhoids, (also known as ‘piles’) are swollen veins. There are two types of haemorrhoids, internal and external.

Internal haemorrhoids originate higher up in your anus and are found inside the lower part of your rectum. Sometimes they can poke through (prolapse) and appear outside your anus. This can be extremely painful.

External haemorrhoids are the most common. They originate and grow just outside the anus. They can cause swelling, a lump, pain, severe itching and discomfort when sitting down. External haemorrhoids grow outside of your anus.

What is haemorrhoid surgery?

There are several different medical procedures for treating haemorrhoids, including ones your doctor can do in the office, through to surgery (haemorrhoidectomy) performed in a day clinic or hospital. They’re all designed to reduce or remove haemorrhoids.

Surgery usually involves cutting off the blood supply to the haemorrhoid or removing them completely.

The type of procedure depends on the severity of the haemorrhoids, your surgeon’s experience and skill and your personal choice.

Learn more about staging of internal haemorrhoids.

Where is it done?

Haemorrhoid surgery can be done as same-day surgery although sometimes you may need to stay in hospital overnight.

How long does it take?

It normally takes around 30 minutes depending on the complexity.

Who is involved?

  • A general surgeon, colorectal surgeon or gastroenterologist
  • Possibly an assistant surgeon
  • Anaesthetist
  • Nurses

CONSIDERING THE PROCEDURE

Alternatives to haemorrhoid surgery

There may be alternatives to haemorrhoid surgery depending on your condition.

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Types of haemorrhoid surgery

There are several different surgical methods for treating haemorrhoids.

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Results vs. risks of the procedure

The benefits and risks of haemorrhoid surgery.

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Choosing a specialist

How to find a surgeon who specialises in this procedure.

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PREPARATION

Questions for your specialist

What you should ask before going ahead with haemorrhoid surgery.

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Preparing for your procedure

Pre-operative tests and preparation prior to haemorrhoid surgery.

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Your anaesthetic options

About the options for anaesthesia and post-op pain relief.

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Staging of internal haemorrhoids

Treatment of internal haemorrhoids depends on their severity.

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YOUR PROCEDURE

Going to hospital

What to expect on the day of your surgery.

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Your procedure

What happens during the procedure.

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RECOVERY AND AFTERCARE

After your procedure

Your hospital stay.

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Aftercare

Resuming activities and watching for problems.

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PATIENT EXPERIENCES

People who’ve had haemorrhoid surgery talk about their preparation, hospital stay and recovery.

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Information is provided by HCF in good faith for the convenience of members. It is not an endorsement or recommendation of any form of treatment nor is it a substitute for medical advice, and you should rely on the advice of your treating doctors in relation to all matters concerning your health. Every effort has been taken to ensure the accuracy of the information, however HCF takes no responsibility for any injury, loss, damage or other consequences of the use of this information.

Is hemorrhoid covered by Medicare?

It is usually covered by Medicare, but you might have to pay a fee above the rebate if the specialist does not bulk bill. Very occasionally, the hemorrhoids are so severe or resistant to other treatments so a "hemorrhoidectomy" is recommended.

What is the best procedure to remove hemorrhoids?

In patients with high-grade, symptomatic hemorrhoids, surgical hemorrhoidectomy is the most effective modality with the lowest recurrence rates, although it causes more pain than conservative methods.

How much is the hemorrhoid surgery?

On MDsave, the cost of a Hemorrhoidectomy ranges from $3,590 to $7,972. Those on high deductible health plans or without insurance can save when they buy their procedure upfront through MDsave.

How do you know if you need surgery for hemorrhoids?

Surgery for hemorrhoids is usually only performed for severe cases, such as when home remedies aren't working, emergencies (such as extreme bleeding), or when they become so bothersome or painful that they impact your lifestyle.