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CPT code 46917: Anal lesion laser, simple, laser surgery2026 Medicare rate & RVUs in Puerto Rico

Reports simple laser destruction of anal lesions, such as condylomata, when laser energy is used instead of another destruction method or excision.

CMS RVU26DEffective Oct 1, 2026One payment locality486 Medicare services in 2024

In Puerto Rico, Medicare pays $468.44 for 46917 in the office and $121.31 when it’s performed in a hospital or facility.

$468.44Office (non-facility)
$121.31Hospital or facility
+0.9%vs the national office rate ($464.27)

Check a contract rate as a % of Medicare · 46917 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 46917 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 46917 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 46917 covers

This service uses laser energy to destroy anal lesions rather than remove them as tissue specimens. A common indication is ablation of anal condylomata (warts). Colorectal or general surgeons typically perform it in an office procedure room or operating room, depending on lesion burden, access, and patient needs.

Report 46917 for simple destruction when laser is the treatment method. Documentation should identify the treated anal site, lesions addressed, technique, and extent to support the code rather than a code for extensive destruction. Use a different family code when lesions are treated chemically, electrically, by cryotherapy, or excised. The 10-day global period includes related postoperative visits during that interval. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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 Puerto Rico compares for 46917

Across 109 of 109 payment localities, the office rate for 46917 runs from $404.24 in Arkansas to $640.08 in San Benito County, CA. Puerto Rico pays $468.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

46917 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$468.44
  2. Los Angeles, CA · California$535.39+$66.95
  3. Washington, DC area · District of Columbia$538.58+$70.14
  4. Miami, FL · Florida$495.17+$26.73
  5. Chicago, IL · Illinois$479.21+$10.77
  6. Manhattan, NY · New York$537.50+$69.06
  7. Alaska · Alaska$516.50+$48.06

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

Every other payment area

46917 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$411.01$110.57
ArkansasArkansas$404.24$109.29
ArizonaArizona$450.71$117.99
Bakersfield, CACalifornia$499.34$123.02
Chico, CACalifornia$498.51$122.19
El Centro, CACalifornia$498.56$122.23
Fresno, CACalifornia$498.51$122.19
Hanford, CACalifornia$498.51$122.19

46917 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.

$404.24

$569.30

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

View every state and territory as a table
46917 office rate range by state
State / territoryOffice rate rangeLocalities
AK$516.501
AL$411.011
AR$404.241
AZ$450.711
CA$498.51–$640.0829
CO$488.011
CT$497.771
DC$538.581
DE$458.901
FL$451.88–$495.173
GA$423.75–$472.692
GU$513.961
HI$513.961
IA$425.071
ID$427.771
IL$435.58–$482.784
IN$430.641
KS$421.791
KY$419.891
LA$418.73–$442.432
MA$484.10–$541.892
MD$468.81–$538.583
ME$429.21–$457.172
MI$431.38–$457.182
MN$468.831
MO$409.86–$445.453
MS$407.191
MT$464.251
NC$434.481
ND$458.521
NE$428.031
NH$479.151
NJ$503.80–$531.642
NM$433.651
NV$463.051
NY$441.77–$550.725
OH$430.211
OK$420.121
OR$459.83–$506.352
PA$431.56–$483.352
PR$468.441
RI$477.361
SC$432.991
SD$457.841
TN$424.071
TX$428.26–$486.068
UT$439.741
VA$454.75–$538.582
VI$468.441
VT$455.561
WA$483.57–$554.692
WI$441.091
WV$417.031
WY$461.751

See 46917 in every payment locality

How the 46917 rate is calculated

Each of 46917’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 · 46917

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.86

1.86 RVUs× 1.000 GPCI

Practice expense11.75

11.75 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

13.9000

Conversion factor

$33.4009

Medicare rate

$464.27

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,633

Code
46917
Physician work
1.86
Practice expense
11.75
Malpractice
0.29

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 46917 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0001.8600
Practice expense11.75× 1.01111.8792
Malpractice0.29× 0.9850.2856
Total RVUs14.0249
Conversion factor× 33.4009

Office rate, Puerto Rico$468.44

Office: (1.86 × 1 + 11.75 × 1.011 + 0.29 × 0.985) × $33.4009 = $468.44

Facility: (1.86 × 1 + 1.47 × 1.011 + 0.29 × 0.985) × $33.4009 = $121.31

Open 46917 in the RVU calculator

Payment rules and modifiers for 46917

46917 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46917

Anal lesion laser, simple, laser surgery

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 · 46917

Anal lesion laser, simple, laser surgery

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

46917 without 51 · national office

$464.27

Anal lesion laser, simple, laser surgery

46917-51 · Second procedure: 50%

$232.14

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 46917

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

Codes related to 46917
CodeHow it relatesOffice range, Puerto Rico
Same family
46900Anal lesion destruction, simple lesionsSimple chemical destruction of anal lesions, rather than laser treatment.$270.59
46910Anal lesion destruction, extensive lesionsSimple electrosurgical destruction of anal lesions.$298.92
46916Anal lesion treatment, cryosurgery, simple lesionsSimple cryosurgical destruction of anal lesions.$256.12
46924Anal lesion destruction, extensive treatmentDestruction of anal lesions when the documented extent is extensive.$627.05
Used instead
46922Anal lesion excision, one or more lesionsReports excision of anal lesions rather than their destruction.$347.16

How 46917 has changed in Puerto Rico

46917 · Office / nonfacility

$468.44

Effective 2026-10-01

The base rate is $43.38 higher than on 2025-10-01, moving from $425.06 to $468.44 (10.2%).

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

    $425.06changed to$468.44

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.91 changed to 1.86
    • Practice expense RVU 10.87 changed to 11.75
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $445.80changed to$425.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.11 changed to 10.87
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $438.52changed to$445.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $460.38changed to$438.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.30 changed to 11.11
    • Malpractice RVU 0.29 changed to 0.30
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $457.48changed to$460.38

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $460.40changed to$457.48

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.02 changed to 11.30
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $459.29changed to$460.40

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.87 changed to 11.02
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $435.04changed to$459.29

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.77 changed to 10.87
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $444.65changed to$435.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.09 changed to 9.77
    • Malpractice RVU 0.27 changed to 0.30
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $468.46changed to$444.65

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.77 changed to 10.09
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $406.01changed to$468.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.79 changed to 10.77
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $339.69changed to$406.01

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.64 changed to 10.79
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $342.03changed to$339.69

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.68 changed to 10.64
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $340.33changed to$342.03

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $328.59changed to$340.33

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.37 changed to 10.68
    • Malpractice RVU 0.32 changed to 0.27
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $341.13changed to$328.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.85 changed to 10.37
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $341.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$468.44$121.31RVU26D
2026-07-01$468.44$121.31RVU26C
2026-04-01$468.44$121.31RVU26B
2026-01-01$468.44$121.31RVU26A
2025-10-01$425.06$127.02RVU25D
2025-07-01$425.06$127.02RVU25C
2025-04-01$425.06$127.02RVU25B
2025-01-01$425.06$127.02RVU25A
2024-10-01$445.80$130.04RVU24D
2024-07-01$445.80$130.04RVU24C
2024-04-01$445.80$130.04RVU24B
2024-03-09$445.80$130.04RVU24AR
2024-01-01$438.52$127.91RVU24A
2023-10-01$460.38$130.76RVU23D
2023-07-01$457.48$130.47RVU23C
2023-04-01$457.48$130.47RVU23B
2023-01-01$457.48$130.47RVU23A
2022-10-01$460.40$130.41RVU22D
2022-07-01$460.40$130.41RVU22C
2022-04-01$460.40$130.41RVU22B
2022-01-01$460.40$130.41RVU22A
2021-10-01$459.29$130.78RVU21D
2021-07-01$459.29$130.78RVU21C
2021-04-01$459.29$130.78RVU21B
2021-01-01$459.29$130.78RVU21A
2020-10-01$435.04$133.10RVU20D
2020-07-01$435.04$133.10RVU20C
2020-04-01$435.04$133.10RVU20B
2020-01-01$435.04$133.10RVU20A
2019-10-01$444.65$134.72RVU19D
2019-07-01$444.65$134.72RVU19C
2019-04-01$444.65$134.72RVU19B
2019-01-01$444.65$134.72RVU19A
2018-10-01$468.46$138.57RVU18D
2018-07-01$468.46$138.57RVU18C
2018-04-01$468.46$138.57RVU18B
2018-01-01$468.46$138.57RVU18AR1
2017-10-01$406.01$125.23RVU17D
2017-07-01$406.01$125.23RVU17C
2017-04-01$406.01$125.23RVU17B
2017-01-01$406.01$125.23RVU17A
2016-10-01$339.69$112.01RVU16D
2016-07-01$339.69$112.01RVU16C
2016-04-01$339.69$112.01RVU16B
2016-01-01$339.69$112.01RVU16A
2015-10-01$342.03$113.02RVU15D
2015-07-01$342.03$113.02RVU15C
2015-04-01$340.33$112.46RVU15B
2015-01-01$340.33$112.46RVU15A
2014-10-01$328.59$111.44RVU14D
2014-07-01$328.59$111.44RVU14C
2014-04-01$328.59$111.44RVU14B
2014-01-01$328.59$111.44RVU14A
2013-10-01$341.13$108.84RVU13D
2013-07-01$341.13$108.84RVU13C
2013-04-01$341.13$108.84RVU13B
2013-01-01$341.13$108.84RVU13AR

Price 46917 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

46917 billing questions

How does 46917 differ from 46916?

Both describe simple destruction of anal lesions, but 46917 is for laser surgery and 46916 is for cryosurgery. The documented treatment method distinguishes them.

When should 46924 be considered instead?

46924 describes extensive destruction of anal lesions. Use the operative documentation of the extent of treatment to distinguish it from simple laser destruction reported with 46917.

Is modifier 50 appropriate for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.

Are related postoperative visits separately payable during the global period?

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

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 46917. 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 46917PPRRVU2026_Oct_nonQPP.csv, line 5,633 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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