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CPT code 46220: Anal tag excision, single external tag2026 Medicare rate & RVUs in Dallas, TX

Reports excision of one external anal skin tag or papilla when the treated tissue is a tag rather than hemorrhoidal disease.

CMS RVU26DEffective Oct 1, 2026One payment locality991 Medicare services in 2024

In Dallas, TX, Medicare pays $273.80 for 46220 in the office and $118.44 when it’s performed in a hospital or facility.

$273.80Office (non-facility)
$118.44Hospital or facility
−0.6%vs the national office rate ($275.56)

Check a contract rate as a % of Medicare · 46220 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 46220 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Dallas, TX
  2. What 46220 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 46220 covers

A clinician removes one external anal skin tag or hypertrophied anal papilla, typically to address irritation, hygiene difficulty, or discomfort. Colorectal and general surgeons commonly perform the procedure in an office or outpatient setting, with the site examined and the lesion excised. The operative note should identify the external lesion and document that one tag or papilla was removed, rather than describing treatment of hemorrhoids or an anal fissure.

Report this code for a single external tag; use the multiple-tag code when more than one is excised. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Dallas, TX compares for 46220

Across 109 of 109 payment localities, the office rate for 46220 runs from $240.77 in Arkansas to $371.17 in San Benito County, CA. Dallas, TX pays $273.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

46220 in Dallas, TX vs other payment areas
  1. Dallas, TX · this page$273.80
  2. Austin, TX · Texas$286.94+$13.14
  3. Beaumont, TX · Texas$255.66−$18.14
  4. Brazoria, TX · Texas$271.93−$1.87
  5. Fort Worth, TX · Texas$271.79−$2.01
  6. Galveston, TX · Texas$272.82−$0.98
  7. Houston, TX · Texas$278.12+$4.32

Other areas in Texas first, then benchmark localities. Bars start at $0.

Every other payment area

46220 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$263.73$115.71
Los Angeles, CACalifornia$313.51$128.98
Washington, DC areaDistrict of Columbia$317.47$133.73
Miami, FLFlorida$299.12$136.74
Chicago, ILIllinois$289.54$132.77
Manhattan, NYNew York$319.17$137.91
AlaskaAlaska$311.30$145.18
AlabamaAlabama$244.67$108.19

46220 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$240.77

$331.81

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
46220 office rate range by state
State / territoryOffice rate rangeLocalities
AK$311.301
AL$244.671
AR$240.771
AZ$267.551
CA$292.44–$371.1729
CO$287.731
CT$295.071
DC$317.471
DE$272.281
FL$271.04–$299.123
GA$254.37–$281.082
GU$300.721
HI$300.721
IA$251.571
ID$253.381
IL$262.44–$289.544
IN$255.001
KS$250.261
KY$251.041
LA$250.61–$264.282
MA$285.74–$318.052
MD$277.85–$317.473
ME$254.82–$270.062
MI$258.24–$274.732
MN$274.931
MO$245.85–$265.333
MS$243.361
MT$275.541
NC$257.761
ND$269.801
NE$253.101
NH$283.101
NJ$298.23–$313.672
NM$259.791
NV$274.151
NY$262.01–$327.555
OH$257.071
OK$250.561
OR$271.83–$297.612
PA$257.52–$287.122
PR$277.761
RI$282.551
SC$257.881
SD$269.131
TN$251.651
TX$255.66–$286.948
UT$261.761
VA$269.08–$317.472
VI$277.761
VT$268.641
WA$285.24–$324.862
WI$259.891
WV$251.771
WY$273.041

See 46220 in every payment locality

How the 46220 rate is calculated

Each of 46220’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 46220

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.57

1.57 RVUs× 1.000 GPCI

Practice expense6.39

6.39 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

8.2500

Conversion factor

$33.4009

Medicare rate

$275.56

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Dallas, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,580

Code
46220
Physician work
1.57
Practice expense
6.39
Malpractice
0.29

GPCI2026.csv

99

Locality
Dallas, TX
Physician work
1.009
Practice expense
0.996
Malpractice
0.858
Office calculation for 46220 in Dallas, TX
ComponentRVULocality factorAdjusted
Physician work1.57× 1.0091.5841
Practice expense6.39× 0.9966.3644
Malpractice0.29× 0.8580.2488
Total RVUs8.1974
Conversion factor× 33.4009

Office rate, Dallas, TX$273.80

Office: (1.57 × 1.009 + 6.39 × 0.996 + 0.29 × 0.858) × $33.4009 = $273.80

Facility: (1.57 × 1.009 + 1.72 × 0.996 + 0.29 × 0.858) × $33.4009 = $118.44

Open 46220 in the RVU calculator

Payment rules and modifiers for 46220

46220 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46220

Anal tag excision, single external tag

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 46220

Anal tag excision, single external tag

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

46220 without 51 · national office

$275.56

Anal tag excision, single external tag

46220-51 · Second procedure: 50%

$137.78

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 46220

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 46220
CodeHow it relatesOffice range, Dallas, TX
Same family
46230Anal tag excision, multiple tagsUsed for excision of multiple external anal tags rather than a single tag.$339.88
Used instead
46250Hemorrhoidectomy, external, two or more groupsUse for excision of multiple external hemorrhoid groups, not isolated skin tags.$532.53
46255Hemorrhoidectomy, one internal and external groupUse when the operative target is one internal or external hemorrhoid group.$576.43

How 46220 has changed in Dallas, TX

46220 · Office / nonfacility

$273.80

Effective 2026-10-01

The base rate is $31.49 higher than on 2025-10-01, moving from $242.31 to $273.80 (13.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $242.31changed to$273.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.61 changed to 1.57
    • Practice expense RVU 5.57 changed to 6.39
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.996
    • Malpractice GPCI 0.877 changed to 0.858

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $252.33changed to$242.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.65 changed to 5.57
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $248.21changed to$252.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $258.22changed to$248.21

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.68 changed to 5.65
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.017 changed to 1.011
    • Practice expense GPCI 1.017 changed to 1.007
    • Malpractice GPCI 0.711 changed to 0.877

  5. January 1, 2023

    RVU23A

    $265.57changed to$258.22

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.72 changed to 5.68
    • Work GPCI 1.023 changed to 1.017
    • Practice expense GPCI 1.026 changed to 1.017
    • Malpractice GPCI 0.546 changed to 0.711

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $259.35changed to$265.57

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.49 changed to 5.72
    • Malpractice RVU 0.28 changed to 0.29

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $236.96changed to$259.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.65 changed to 5.49
    • Work GPCI 1.018 changed to 1.023
    • Practice expense GPCI 1.020 changed to 1.026
    • Malpractice GPCI 0.657 changed to 0.546

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $224.44changed to$236.96

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.30 changed to 4.65
    • Malpractice RVU 0.31 changed to 0.28
    • Work GPCI 1.012 changed to 1.018
    • Practice expense GPCI 1.014 changed to 1.020
    • Malpractice GPCI 0.768 changed to 0.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $214.06changed to$224.44

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.03 changed to 4.30
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $211.13changed to$214.06

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.97 changed to 4.03
    • Work GPCI 1.015 changed to 1.012
    • Practice expense GPCI 1.012 changed to 1.014
    • Malpractice GPCI 0.770 changed to 0.768

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $210.31changed to$211.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.96 changed to 3.97
    • Malpractice RVU 0.31 changed to 0.30
    • Work GPCI 1.018 changed to 1.015
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.772 changed to 0.770

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $211.88changed to$210.31

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.99 changed to 3.96
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $210.83changed to$211.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $210.16changed to$210.83

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.95 changed to 3.99
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.014 changed to 1.018
    • Practice expense GPCI 1.013 changed to 1.009
    • Malpractice GPCI 0.803 changed to 0.772

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $217.07changed to$210.16

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.43 changed to 3.95
    • Malpractice RVU 0.30 changed to 0.29
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.017 changed to 1.013
    • Malpractice GPCI 0.834 changed to 0.803

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $217.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$273.80$118.44RVU26D
2026-07-01$273.80$118.44RVU26C
2026-04-01$273.80$118.44RVU26B
2026-01-01$273.80$118.44RVU26A
2025-10-01$242.31$119.51RVU25D
2025-07-01$242.31$119.51RVU25C
2025-04-01$242.31$119.51RVU25B
2025-01-01$242.31$119.51RVU25A
2024-10-01$252.33$122.27RVU24D
2024-07-01$252.33$122.27RVU24C
2024-04-01$252.33$122.27RVU24B
2024-03-09$252.33$122.27RVU24AR
2024-01-01$248.21$120.28RVU24A
2023-10-01$258.22$122.44RVU23D
2023-07-01$258.22$122.44RVU23C
2023-04-01$258.22$122.44RVU23B
2023-01-01$258.22$122.44RVU23A
2022-10-01$265.57$122.48RVU22D
2022-07-01$265.57$122.48RVU22C
2022-04-01$265.57$122.48RVU22B
2022-01-01$265.57$122.48RVU22A
2021-10-01$259.35$121.87RVU21D
2021-07-01$259.35$121.87RVU21C
2021-04-01$259.35$121.87RVU21B
2021-01-01$259.35$121.87RVU21A
2020-10-01$236.96$122.48RVU20D
2020-07-01$236.96$122.48RVU20C
2020-04-01$236.96$122.48RVU20B
2020-01-01$236.96$122.48RVU20A
2019-10-01$224.44$122.85RVU19D
2019-07-01$224.44$122.85RVU19C
2019-04-01$224.44$122.85RVU19B
2019-01-01$224.44$122.85RVU19A
2018-10-01$214.06$122.07RVU18D
2018-07-01$214.06$122.07RVU18C
2018-04-01$214.06$122.07RVU18B
2018-01-01$214.06$122.07RVU18AR1
2017-10-01$211.13$121.78RVU17D
2017-07-01$211.13$121.78RVU17C
2017-04-01$211.13$121.78RVU17B
2017-01-01$211.13$121.78RVU17A
2016-10-01$210.31$121.44RVU16D
2016-07-01$210.31$121.44RVU16C
2016-04-01$210.31$121.44RVU16B
2016-01-01$210.31$121.44RVU16A
2015-10-01$211.88$122.33RVU15D
2015-07-01$211.88$122.33RVU15C
2015-04-01$210.83$121.72RVU15B
2015-01-01$210.83$121.72RVU15A
2014-10-01$210.16$121.62RVU14D
2014-07-01$210.16$121.62RVU14C
2014-04-01$210.16$121.62RVU14B
2014-01-01$210.16$121.62RVU14A
2013-10-01$217.07$121.57RVU13D
2013-07-01$217.07$121.57RVU13C
2013-04-01$217.07$121.57RVU13B
2013-01-01$217.07$121.57RVU13AR

Price 46220 for an earlier date of service

Where the Dallas, TX rate applies

Dallas, TX is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

46220 billing questions

When should this code be chosen over 46230?

Use this code when one external anal tag or papilla is excised. Use 46230 when multiple external tags are removed.

Can this code be reported for hemorrhoid removal?

No. It describes excision of an external tag or papilla, not hemorrhoidal tissue. Select the hemorrhoid procedure that matches the documented disease and operative treatment.

Are related postoperative visits separately reported?

Visits related to the procedure during its 10-day global period are included.

Should modifier 50 be appended for tags on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does Medicare handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 46220PPRRVU2026_Oct_nonQPP.csv, line 5,580 (RVU26D)
Geographic factors for Dallas, TXGPCI2026.csv, line 99 (RVU26D)

Open CMS sourceHow we calculate rates

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