CPT code 46900: Anal lesion destruction, simple lesions2026 Medicare rate & RVUs in Washington, DC area

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 Washington, DC area, Medicare pays $308.08 for 46900 in the office and $147.54 when it’s performed in a hospital or facility.

$308.08Office (non-facility)
$147.54Hospital or facility
+14.7%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 Washington, DC area
  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 Washington, DC area 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. Washington, DC area pays $308.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

46900 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$308.08
  2. Los Angeles, CA · California$304.36−$3.72
  3. Miami, FL · Florida$289.93−$18.15
  4. Chicago, IL · Illinois$281.21−$26.87
  5. Manhattan, NY · New York$309.64+$1.56
  6. Alaska · Alaska$308.56+$0.48
  7. Alabama · Alabama$240.06−$68.02

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

46900 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$236.45$119.39
ArizonaArizona$261.16$129.11
Bakersfield, CACalifornia$285.31$135.95
Chico, CACalifornia$284.55$135.19
El Centro, CACalifornia$284.60$135.24
Fresno, CACalifornia$284.55$135.19
Hanford, CACalifornia$284.55$135.19
Madera, CACalifornia$284.55$135.19

46900 rates by state

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

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 46900 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0541.9604
Practice expense5.92× 1.1786.9738
Malpractice0.26× 1.1130.2894
Total RVUs9.2236
Conversion factor× 33.4009

Office rate, Washington, DC area$308.08

Office: (1.86 × 1.054 + 5.92 × 1.178 + 0.26 × 1.113) × $33.4009 = $308.08

Facility: (1.86 × 1.054 + 1.84 × 1.178 + 0.26 × 1.113) × $33.4009 = $147.54

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

How 46900 has changed in Washington, DC area

46900 · Office / nonfacility

$308.08

Effective 2026-10-01

The base rate is $35.16 higher than on 2025-10-01, moving from $272.92 to $308.08 (12.9%).

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

    $272.92changed to$308.08

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $278.88changed to$272.92

    • 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

    $274.33changed to$278.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $285.71changed to$274.33

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.02 changed to 5.08
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $293.87changed to$285.71

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $296.74changed to$293.87

    • 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

    $287.01changed to$296.74

    • 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 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $283.10changed to$287.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.58 changed to 4.59
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $291.03changed to$283.10

    • 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

    $288.73changed to$291.03

    • 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 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $288.35changed to$288.73

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $291.12changed to$288.35

    • 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

    $289.67changed to$291.12

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $283.72changed to$289.67

    • 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 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $290.84changed to$283.72

    • 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 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $290.84

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$308.08$147.54RVU26D
2026-07-01$308.08$147.54RVU26C
2026-04-01$308.08$147.54RVU26B
2026-01-01$308.08$147.54RVU26A
2025-10-01$272.92$153.39RVU25D
2025-07-01$272.92$153.39RVU25C
2025-04-01$272.92$153.39RVU25B
2025-01-01$272.92$153.39RVU25A
2024-10-01$278.88$155.88RVU24D
2024-07-01$278.88$155.88RVU24C
2024-04-01$278.88$155.88RVU24B
2024-03-09$278.88$155.88RVU24AR
2024-01-01$274.33$153.33RVU24A
2023-10-01$285.71$158.59RVU23D
2023-07-01$285.71$158.59RVU23C
2023-04-01$285.71$158.59RVU23B
2023-01-01$285.71$158.59RVU23A
2022-10-01$293.87$160.85RVU22D
2022-07-01$293.87$160.85RVU22C
2022-04-01$293.87$160.85RVU22B
2022-01-01$293.87$160.85RVU22A
2021-10-01$296.74$159.59RVU21D
2021-07-01$296.74$159.59RVU21C
2021-04-01$296.74$159.59RVU21B
2021-01-01$296.74$159.59RVU21A
2020-10-01$287.01$161.43RVU20D
2020-07-01$287.01$161.43RVU20C
2020-04-01$287.01$161.43RVU20B
2020-01-01$287.01$161.43RVU20A
2019-10-01$283.10$159.77RVU19D
2019-07-01$283.10$159.77RVU19C
2019-04-01$283.10$159.77RVU19B
2019-01-01$283.10$159.77RVU19A
2018-10-01$291.03$160.46RVU18D
2018-07-01$291.03$160.46RVU18C
2018-04-01$291.03$160.46RVU18B
2018-01-01$291.03$160.46RVU18AR1
2017-10-01$288.73$160.72RVU17D
2017-07-01$288.73$160.72RVU17C
2017-04-01$288.73$160.72RVU17B
2017-01-01$288.73$160.72RVU17A
2016-10-01$288.35$160.64RVU16D
2016-07-01$288.35$160.64RVU16C
2016-04-01$288.35$160.64RVU16B
2016-01-01$288.35$160.64RVU16A
2015-10-01$291.12$162.09RVU15D
2015-07-01$291.12$162.09RVU15C
2015-04-01$289.67$161.28RVU15B
2015-01-01$289.67$161.28RVU15A
2014-10-01$283.72$159.71RVU14D
2014-07-01$283.72$159.71RVU14C
2014-04-01$283.72$159.71RVU14B
2014-01-01$283.72$159.71RVU14A
2013-10-01$290.84$159.18RVU13D
2013-07-01$290.84$159.18RVU13C
2013-04-01$290.84$159.18RVU13B
2013-01-01$290.84$159.18RVU13AR

Price 46900 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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 Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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