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CPT code 46910: Anal lesion destruction, extensive lesions2026 Medicare rate & RVUs in Iowa

Reports extensive destruction of anal lesions, such as condylomas or papillomas, when the documented procedure meets this code’s extent criteria.

CMS RVU26DEffective Oct 1, 2026One payment locality1.1K Medicare services in 2024

In Iowa, Medicare pays $271.48 for 46910 in the office and $118.98 when it’s performed in a hospital or facility.

$271.48Office (non-facility)
$118.98Hospital or facility
−8.5%vs the national office rate ($296.60)

Check a contract rate as a % of Medicare · 46910 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 46910 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 46910 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 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.

How Iowa compares for 46910

Across 109 of 109 payment localities, the office rate for 46910 runs from $260.09 in Arkansas to $397.99 in San Benito County, CA. Iowa pays $271.48. The RVUs are the same everywhere; the geographic indexes change the dollars.

46910 in Iowa vs other payment areas
  1. Iowa · this page$271.48
  2. Los Angeles, CA · California$336.86+$65.38
  3. Washington, DC area · District of Columbia$341.04+$69.56
  4. Miami, FL · Florida$321.12+$49.64
  5. Chicago, IL · Illinois$311.13+$39.65
  6. Manhattan, NY · New York$342.81+$71.33
  7. Alaska · Alaska$337.75+$66.27

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

Every other payment area

46910 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$264.19$118.36
ArkansasArkansas$260.09$116.92
ArizonaArizona$288.20$126.70
Bakersfield, CACalifornia$315.41$132.74
Chico, CACalifornia$314.55$131.88
El Centro, CACalifornia$314.60$131.93
Fresno, CACalifornia$314.55$131.88
Hanford, CACalifornia$314.55$131.88

46910 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.

$260.09

$356.27

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

View every state and territory as a table
46910 office rate range by state
State / territoryOffice rate rangeLocalities
AK$337.751
AL$264.191
AR$260.091
AZ$288.201
CA$314.55–$397.9929
CO$309.521
CT$317.231
DC$341.041
DE$293.211
FL$291.76–$321.123
GA$274.28–$302.392
GU$323.131
HI$323.131
IA$271.481
ID$273.361
IL$282.71–$311.134
IN$275.061
KS$270.081
KY$270.831
LA$270.37–$284.722
MA$307.46–$341.592
MD$299.09–$341.043
ME$274.86–$290.882
MI$278.37–$295.622
MN$296.051
MO$265.36–$285.853
MS$262.791
MT$296.581
NC$277.941
ND$290.651
NE$273.081
NH$304.551
NJ$320.71–$337.112
NM$279.981
NV$295.151
NY$282.40–$351.595
OH$277.151
OK$270.351
OR$292.73–$319.942
PA$277.64–$308.852
PR$298.921
RI$304.111
SC$278.041
SD$289.951
TN$271.541
TX$275.69–$308.608
UT$282.111
VA$289.84–$341.042
VI$298.921
VT$289.411
WA$306.91–$348.822
WI$280.241
WV$271.521
WY$293.991

See 46910 in every payment locality

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

Office or facility?

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.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,631

Code
46910
Physician work
1.86
Practice expense
6.72
Malpractice
0.30

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 46910 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0001.8600
Practice expense6.72× 0.9156.1488
Malpractice0.30× 0.3970.1191
Total RVUs8.1279
Conversion factor× 33.4009

Office rate, Iowa$271.48

Office: (1.86 × 1 + 6.72 × 0.915 + 0.3 × 0.397) × $33.4009 = $271.48

Facility: (1.86 × 1 + 1.73 × 0.915 + 0.3 × 0.397) × $33.4009 = $118.98

Open 46910 in the RVU calculator

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

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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

Codes related to 46910

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

Codes related to 46910
CodeHow it relatesOffice range, Iowa
Same family
46900Anal lesion destruction, simple lesionsSimple anal lesion destruction; distinguish it from this code’s extensive service.$246.50
46924Anal lesion destruction, extensive treatmentAnother anal lesion destruction code; select according to its specific CPT criteria.$569.09
Used instead
46916Anal lesion treatment, cryosurgery, simple lesionsUse for cryosurgery of anal lesions rather than the destruction service represented here.$234.40
46917Anal lesion laser, simple, laser surgeryUse for laser surgery of anal lesions when that technique is performed.$425.07
46922Anal lesion excision, one or more lesionsDescribes excision of anal lesions rather than their destruction.$314.14

How 46910 has changed in Iowa

46910 · Office / nonfacility

$271.48

Effective 2026-10-01

The base rate is $35.30 higher than on 2025-10-01, moving from $236.18 to $271.48 (14.9%).

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

    $236.18changed to$271.48

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.91 changed to 1.86
    • Practice expense RVU 5.76 changed to 6.72
    • Malpractice RVU 0.29 changed to 0.30
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $242.89changed to$236.18

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.74 changed to 5.76
    • Malpractice RVU 0.32 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $238.93changed to$242.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $245.29changed to$238.93

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.71 changed to 5.74
    • Malpractice RVU 0.30 changed to 0.32
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $252.08changed to$245.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.78 changed to 5.71
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $254.02changed to$252.08

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $243.08changed to$254.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.18 changed to 5.78
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $242.55changed to$243.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.17 changed to 5.18
    • Malpractice RVU 0.31 changed to 0.30
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $242.79changed to$242.55

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.19 changed to 5.17
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $238.58changed to$242.79

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.09 changed to 5.19
    • Malpractice RVU 0.32 changed to 0.30
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $237.04changed to$238.58

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.07 changed to 5.09
    • Malpractice RVU 0.34 changed to 0.32
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $237.86changed to$237.04

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.08 changed to 5.07
    • Malpractice RVU 0.32 changed to 0.34

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $236.68changed to$237.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $233.49changed to$236.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.99 changed to 5.08
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $238.35changed to$233.49

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.57 changed to 4.99
    • Malpractice RVU 0.34 changed to 0.33
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $238.35

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$271.48$118.98RVU26D
2026-07-01$271.48$118.98RVU26C
2026-04-01$271.48$118.98RVU26B
2026-01-01$271.48$118.98RVU26A
2025-10-01$236.18$121.88RVU25D
2025-07-01$236.18$121.88RVU25C
2025-04-01$236.18$121.88RVU25B
2025-01-01$236.18$121.88RVU25A
2024-10-01$242.89$124.98RVU24D
2024-07-01$242.89$124.98RVU24C
2024-04-01$242.89$124.98RVU24B
2024-03-09$242.89$124.98RVU24AR
2024-01-01$238.93$122.94RVU24A
2023-10-01$245.29$125.02RVU23D
2023-07-01$245.29$125.02RVU23C
2023-04-01$245.29$125.02RVU23B
2023-01-01$245.29$125.02RVU23A
2022-10-01$252.08$126.53RVU22D
2022-07-01$252.08$126.53RVU22C
2022-04-01$252.08$126.53RVU22B
2022-01-01$252.08$126.53RVU22A
2021-10-01$254.02$126.16RVU21D
2021-07-01$254.02$126.16RVU21C
2021-04-01$254.02$126.16RVU21B
2021-01-01$254.02$126.16RVU21A
2020-10-01$243.08$126.88RVU20D
2020-07-01$243.08$126.88RVU20C
2020-04-01$243.08$126.88RVU20B
2020-01-01$243.08$126.88RVU20A
2019-10-01$242.55$127.17RVU19D
2019-07-01$242.55$127.17RVU19C
2019-04-01$242.55$127.17RVU19B
2019-01-01$242.55$127.17RVU19A
2018-10-01$242.79$127.53RVU18D
2018-07-01$242.79$127.53RVU18C
2018-04-01$242.79$127.53RVU18B
2018-01-01$242.79$127.53RVU18AR1
2017-10-01$238.58$126.25RVU17D
2017-07-01$238.58$126.25RVU17C
2017-04-01$238.58$126.25RVU17B
2017-01-01$238.58$126.25RVU17A
2016-10-01$237.04$126.04RVU16D
2016-07-01$237.04$126.04RVU16C
2016-04-01$237.04$126.04RVU16B
2016-01-01$237.04$126.04RVU16A
2015-10-01$237.86$126.46RVU15D
2015-07-01$237.86$126.46RVU15C
2015-04-01$236.68$125.83RVU15B
2015-01-01$236.68$125.83RVU15A
2014-10-01$233.49$126.12RVU14D
2014-07-01$233.49$126.12RVU14C
2014-04-01$233.49$126.12RVU14B
2014-01-01$233.49$126.12RVU14A
2013-10-01$238.35$124.58RVU13D
2013-07-01$238.35$124.58RVU13C
2013-04-01$238.35$124.58RVU13B
2013-01-01$238.35$124.58RVU13AR

Price 46910 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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
RVUs for 46910PPRRVU2026_Oct_nonQPP.csv, line 5,631 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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