CPT code 46910: Anal lesion destruction, extensive lesions2026 Medicare rate & RVUs in California
Reports extensive destruction of anal lesions, such as condylomas or papillomas, when the documented procedure meets this code’s extent criteria.
Medicare pays $314.55–$397.99 for 46910 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 46910 covers
This code represents extensive destruction of lesions on the anus, rather than removal by excision. Typical targets include anal condylomas or papillomas. A colorectal or general surgeon commonly performs the procedure in an office procedure room, ambulatory setting, or operating room, depending on the extent of treatment and the patient’s needs.
Choose this code when the operative or procedure note supports extensive lesion destruction; use the documented treatment method, lesion distribution, and scope to distinguish it from simple destruction or codes naming a specific technique. The note should identify the anal lesions treated and describe the extent of treatment. Medicare assigns a 10-day global period, so related postoperative visits during that 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. Medicare does not pay an assistant at surgery for this code; 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.
Where 46910 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$314.55 to $397.99
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $315.41 | $132.74 |
| Chico, CA | $314.55 | $131.88 |
| El Centro, CA | $314.60 | $131.93 |
| Fresno, CA | $314.55 | $131.88 |
| Hanford, CA | $314.55 | $131.88 |
| Los Angeles, CA | $336.86 | $139.68 |
| Madera, CA | $314.55 | $131.88 |
| Marin County, CA | $389.11 | $154.10 |
| Merced, CA | $314.55 | $131.88 |
| Modesto, CA | $314.55 | $131.88 |
| Napa, CA | $366.96 | $147.29 |
| Oxnard, CA | $335.41 | $138.41 |
| Redding, CA | $314.55 | $131.88 |
| Rest of California | $314.55 | $131.88 |
| Riverside, CA | $317.79 | $135.12 |
| Sacramento, CA | $330.77 | $136.94 |
| Salinas, CA | $329.56 | $136.39 |
| San Benito County, CA | $397.99 | $157.65 |
| San Diego, CA | $337.87 | $138.53 |
| San Francisco, CA | $388.77 | $153.76 |
| San Luis Obispo, CA | $324.21 | $134.37 |
| Santa Clara County, CA | $396.60 | $156.26 |
| Santa Cruz, CA | $341.51 | $139.01 |
| Santa Maria, CA | $330.95 | $136.61 |
| Santa Rosa, CA | $344.99 | $140.32 |
| Stockton, CA | $314.55 | $131.88 |
| Vallejo, CA | $366.47 | $146.80 |
| Visalia, CA | $314.55 | $131.88 |
| Yuba City, CA | $314.55 | $131.88 |
How the 46910 rate is calculated
Each of 46910’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 · 46910
RVUs × geographic indexes × conversion factor
Work1.86
1.86 RVUs× 1.000 GPCI
Practice expense6.72
6.72 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
8.8800
Conversion factor
$33.4009
Medicare rate
$296.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46910
46910 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46910
Anal lesion destruction, extensive lesions
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 46910
Anal lesion destruction, extensive 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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
46910 without 51 · national office
$296.60
Anal lesion destruction, extensive lesions
46910-51 · Second procedure: 50%
$148.30
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%).
46910 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46900Anal lesion destructionSimple lesions
- 46900 represents simple anal lesion destruction; 46910 is the extensive-destruction code. The documented scope of treatment guides the choice.
- 46916Anal lesion treatmentCryosurgery, simple lesions
- 46916 specifically identifies cryosurgery. Choose it when freezing is the documented treatment method, rather than reporting 46910 based only on lesion extent.
- 46917Anal lesion laserSimple, laser surgery
- 46917 identifies laser surgery of anal lesions. Use it when laser treatment is performed; 46910 represents extensive destruction without that technique-specific label.
- 46922Anal lesion excisionOne or more lesions
- 46922 is for excising anal lesions. Choose 46910 when the lesions are destroyed rather than excised.
46910 billing questions
How does 46910 differ from 46900?
46910 is for extensive anal lesion destruction; 46900 is the simple-destruction code. The documentation should support the extent selected.
When should a cryosurgery or laser code be considered instead?
Use 46916 for cryosurgery and 46917 for laser surgery when the documented procedure uses those named techniques. Do not select 46910 solely because lesions are extensive if a technique-specific code describes the service.
Is destruction reported instead of excision?
Yes. When the lesions are removed by excision, consider 46922 rather than a destruction code.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in 46910.
Can modifier 50 be used for lesions on both sides?
No. Bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 46910. 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
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