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CPT code 46900: Anal lesion destruction, simple lesions2026 Medicare rate & RVUs in Los Angeles, CA

Reports destruction of simple anal lesions, such as condyloma, when the service treats limited lesions rather than extensive disease or removes tissue by excision.

CMS RVU26DEffective Oct 1, 2026One payment locality692 Medicare services in 2024

In Los Angeles, CA, Medicare pays $304.36 for 46900 in the office and $143.14 when it’s performed in a hospital or facility.

$304.36Office (non-facility)
$143.14Hospital or facility
+13.3%vs the national office rate ($268.54)

Check a contract rate as a % of Medicare · 46900 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 46900 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 46900 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 46900 covers

This code covers destruction of simple lesions on the anus, including lesions such as condyloma, papilloma, or molluscum contagiosum. A colorectal or general surgeon commonly performs the service in an office or outpatient setting. The treatment destroys the lesion rather than removing it as a specimen for excisional pathology. The distinction from more extensive treatment and from technique-specific procedures is central to code selection.

Document the lesion location, number and extent, the destruction performed, and why the service meets the simple-lesion level. Report the code for the session’s service rather than treating each lesion as a separate unit. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anal-site service. Medicare does not pay an assistant at surgery, 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 Los Angeles, CA compares for 46900

Across 109 of 109 payment localities, the office rate for 46900 runs from $236.45 in Arkansas to $358.75 in San Benito County, CA. Los Angeles, CA pays $304.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

46900 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$304.36
  2. Bakersfield, CA · California$285.31−$19.05
  3. Chico, CA · California$284.55−$19.81
  4. El Centro, CA · California$284.60−$19.76
  5. Fresno, CA · California$284.55−$19.81
  6. Hanford, CA · California$284.55−$19.81
  7. Madera, CA · California$284.55−$19.81

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

Every other payment area

46900 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$284.55$135.19
Modesto, CACalifornia$284.55$135.19
Napa, CACalifornia$331.06$151.45
Oxnard, CACalifornia$303.00$141.92
Redding, CACalifornia$284.55$135.19
Rest of CaliforniaCalifornia$284.55$135.19
Riverside, CACalifornia$287.37$138.01
Sacramento, CACalifornia$298.98$140.49

46900 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.

$236.45

$321.65

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

View every state and territory as a table
46900 office rate range by state
State / territoryOffice rate rangeLocalities
AK$308.561
AL$240.061
AR$236.451
AZ$261.161
CA$284.55–$358.7529
CO$280.041
CT$286.831
DC$308.081
DE$265.601
FL$264.21–$289.933
GA$248.86–$273.642
GU$291.981
HI$291.981
IA$246.501
ID$248.151
IL$256.23–$281.214
IN$249.651
KS$245.251
KY$245.861
LA$245.44–$258.062
MA$278.25–$308.502
MD$270.83–$308.083
ME$249.44–$263.562
MI$252.46–$267.582
MN$268.161
MO$241.03–$259.073
MS$238.791
MT$268.531
NC$252.161
ND$263.381
NE$247.921
NH$275.561
NJ$290.06–$304.692
NM$253.881
NV$267.291
NY$256.08–$317.335
OH$251.411
OK$245.451
OR$265.17–$289.262
PA$251.85–$279.442
PR$270.591
RI$275.311
SC$252.211
SD$262.781
TN$246.531
TX$250.13–$279.158
UT$255.791
VA$262.63–$308.082
VI$270.591
VT$262.281
WA$277.76–$314.952
WI$254.231
WV$246.381
WY$266.291

See 46900 in every payment locality

How the 46900 rate is calculated

Each of 46900’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 · 46900

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.86

1.86 RVUs× 1.000 GPCI

Practice expense5.92

5.92 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

8.0400

Conversion factor

$33.4009

Medicare rate

$268.54

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

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,630

Code
46900
Physician work
1.86
Practice expense
5.92
Malpractice
0.26

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 46900 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0411.9363
Practice expense5.92× 1.1837.0034
Malpractice0.26× 0.6640.1726
Total RVUs9.1123
Conversion factor× 33.4009

Office rate, Los Angeles, CA$304.36

Office: (1.86 × 1.041 + 5.92 × 1.183 + 0.26 × 0.664) × $33.4009 = $304.36

Facility: (1.86 × 1.041 + 1.84 × 1.183 + 0.26 × 0.664) × $33.4009 = $143.14

Open 46900 in the RVU calculator

Payment rules and modifiers for 46900

46900 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46900

Anal lesion destruction, simple lesions

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 · 46900

Anal lesion destruction, simple lesions

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

46900 without 51 · national office

$268.54

Anal lesion destruction, simple lesions

46900-51 · Second procedure: 50%

$134.27

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 46900

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

Codes related to 46900
CodeHow it relatesOffice range, Los Angeles, CA
Same family
46910Anal lesion destruction, extensive lesionsMore extensive anal lesion destruction level.$336.86
Used instead
46916Anal lesion treatment, cryosurgery, simple lesionsUsed when anal lesion destruction is performed by cryosurgery.$288.41
46917Anal lesion laser, simple, laser surgeryUsed when anal lesion destruction is performed by laser.$535.39
46922Anal lesion excision, one or more lesionsFor anal lesions removed by excision rather than destruction.$392.32

How 46900 has changed in Los Angeles, CA

46900 · Office / nonfacility

$304.36

Effective 2026-10-01

The base rate is $36.21 higher than on 2025-10-01, moving from $268.15 to $304.36 (13.5%).

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

    $268.15changed to$304.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.91 changed to 1.86
    • Practice expense RVU 5.12 changed to 5.92
    • Malpractice RVU 0.27 changed to 0.26
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $274.13changed to$268.15

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.08 changed to 5.12
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $269.65changed to$274.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $275.60changed to$269.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.02 changed to 5.08
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $278.32changed to$275.60

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.98 changed to 5.02
    • Malpractice RVU 0.25 changed to 0.26
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $281.04changed to$278.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.99 changed to 4.98

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $274.04changed to$281.04

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.59 changed to 4.99
    • Malpractice RVU 0.27 changed to 0.25
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $273.03changed to$274.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.58 changed to 4.59
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $280.78changed to$273.03

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.77 changed to 4.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $277.84changed to$280.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.72 changed to 4.77
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $276.91changed to$277.84

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $279.58changed to$276.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.76 changed to 4.72

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $278.18changed to$279.58

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $271.41changed to$278.18

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.63 changed to 4.76
    • Malpractice RVU 0.29 changed to 0.28
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $277.26changed to$271.41

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.18 changed to 4.63
    • Malpractice RVU 0.30 changed to 0.29
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$277.26

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$304.36$143.14RVU26D
2026-07-01$304.36$143.14RVU26C
2026-04-01$304.36$143.14RVU26B
2026-01-01$304.36$143.14RVU26A
2025-10-01$268.15$148.42RVU25D
2025-07-01$268.15$148.42RVU25C
2025-04-01$268.15$148.42RVU25B
2025-01-01$268.15$148.42RVU25A
2024-10-01$274.13$150.92RVU24D
2024-07-01$274.13$150.92RVU24C
2024-04-01$274.13$150.92RVU24B
2024-03-09$274.13$150.92RVU24AR
2024-01-01$269.65$148.45RVU24A
2023-10-01$275.60$151.52RVU23D
2023-07-01$275.60$151.52RVU23C
2023-04-01$275.60$151.52RVU23B
2023-01-01$275.60$151.52RVU23A
2022-10-01$278.32$151.86RVU22D
2022-07-01$278.32$151.86RVU22C
2022-04-01$278.32$151.86RVU22B
2022-01-01$278.32$151.86RVU22A
2021-10-01$281.04$150.66RVU21D
2021-07-01$281.04$150.66RVU21C
2021-04-01$281.04$150.66RVU21B
2021-01-01$281.04$150.66RVU21A
2020-10-01$274.04$153.08RVU20D
2020-07-01$274.04$153.08RVU20C
2020-04-01$274.04$153.08RVU20B
2020-01-01$274.04$153.08RVU20A
2019-10-01$273.03$152.56RVU19D
2019-07-01$273.03$152.56RVU19C
2019-04-01$273.03$152.56RVU19B
2019-01-01$273.03$152.56RVU19A
2018-10-01$280.78$153.24RVU18D
2018-07-01$280.78$153.24RVU18C
2018-04-01$280.78$153.24RVU18B
2018-01-01$280.78$153.24RVU18AR1
2017-10-01$277.84$153.66RVU17D
2017-07-01$277.84$153.66RVU17C
2017-04-01$277.84$153.66RVU17B
2017-01-01$277.84$153.66RVU17A
2016-10-01$276.91$153.86RVU16D
2016-07-01$276.91$153.86RVU16C
2016-04-01$276.91$153.86RVU16B
2016-01-01$276.91$153.86RVU16A
2015-10-01$279.58$155.25RVU15D
2015-07-01$279.58$155.25RVU15C
2015-04-01$278.18$154.48RVU15B
2015-01-01$278.18$154.48RVU15A
2014-10-01$271.41$151.94RVU14D
2014-07-01$271.41$151.94RVU14C
2014-04-01$271.41$151.94RVU14B
2014-01-01$271.41$151.94RVU14A
2013-10-01$277.26$150.44RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46900 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

46900 billing questions

How do I distinguish this code from 46910?

Use 46900 for simple anal lesion destruction. Code 46910 represents the more extensive level, so document the scope and extent that support the selected level.

When would 46916 or 46917 be more appropriate?

Those codes identify cryosurgery and laser surgery, respectively. Choose the code that reflects the documented destruction method rather than reporting 46900 for those technique-specific services.

Is excision of an anal lesion reported with 46900?

No. When the lesion is cut out and removed, consider 46922; 46900 describes destruction rather than excision.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can modifier 50 be used for lesions on both sides?

No. Modifier 50 is inappropriate for this anal-site service.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. 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 46900PPRRVU2026_Oct_nonQPP.csv, line 5,630 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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