CPT code 46922: Anal lesion excision, one or more lesions2026 Medicare rate & RVUs in North Carolina

Surgical removal of one or more anal lesions, reported when the clinician excises tissue rather than destroying the lesion with an ablative method.

CMS RVU26DEffective Oct 1, 2026One payment locality2.8K Medicare services in 2024

In North Carolina, Medicare pays $321.92 for 46922 in the office and $125.90 when it’s performed in a hospital or facility.

$321.92Office (non-facility)
$125.90Hospital or facility
−6.5%vs the national office rate ($344.36)

Check a contract rate as a % of Medicare · 46922 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 46922 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 46922 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 46922 covers

Code 46922 represents surgical excision of one or more lesions of the anus. A colorectal surgeon, general surgeon, or other qualified physician may remove the lesion with cutting instruments in an office procedure room or operating room; anesthesia and setting depend on the clinical circumstances. A specimen may be sent for histopathologic examination, which is a separate service from the excision.

Report the excision service, not a separate unit for each lesion removed. Document the anal site, lesion findings, excisional technique, and number treated. CMS assigns a 10-day minor-procedure global period, so related postoperative visits during that period are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this 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 North Carolina compares for 46922

Across 109 of 109 payment localities, the office rate for 46922 runs from $300.43 in Arkansas to $465.05 in San Benito County, CA. North Carolina pays $321.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

46922 in North Carolina vs other payment areas
  1. North Carolina · this page$321.92
  2. Los Angeles, CA · California$392.32+$70.40
  3. Washington, DC area · District of Columbia$397.17+$75.25
  4. Miami, FL · Florida$373.83+$51.91
  5. Chicago, IL · Illinois$361.72+$39.80
  6. Manhattan, NY · New York$399.16+$77.24
  7. Alaska · Alaska$387.59+$65.67

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

Every other payment area

46922 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$305.37$121.54
ArkansasArkansas$300.43$119.96
ArizonaArizona$334.26$130.68
Bakersfield, CACalifornia$366.78$136.52
Chico, CACalifornia$365.78$135.52
El Centro, CACalifornia$365.84$135.58
Fresno, CACalifornia$365.78$135.52
Hanford, CACalifornia$365.78$135.52

46922 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.

$300.43

$415.41

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

View every state and territory as a table
46922 office rate range by state
State / territoryOffice rate rangeLocalities
AK$387.591
AL$305.371
AR$300.431
AZ$334.261
CA$365.78–$465.0529
CO$359.771
CT$368.941
DC$397.171
DE$340.221
FL$338.52–$373.833
GA$317.49–$351.292
GU$376.321
HI$376.321
IA$314.141
ID$316.411
IL$327.62–$361.724
IN$318.461
KS$312.461
KY$313.351
LA$312.78–$330.062
MA$357.24–$398.012
MD$347.24–$397.173
ME$318.20–$337.492
MI$322.41–$343.152
MN$343.731
MO$306.76–$331.423
MS$303.671
MT$344.341
NC$321.921
ND$337.221
NE$316.081
NH$353.941
NJ$372.87–$392.332
NM$324.351
NV$342.631
NY$327.28–$409.715
OH$320.951
OK$312.771
OR$339.71–$372.272
PA$321.54–$358.882
PR$347.161
RI$353.161
SC$322.021
SD$336.381
TN$314.211
TX$319.19–$358.798
UT$326.921
VA$336.23–$397.172
VI$347.161
VT$335.721
WA$356.62–$406.612
WI$324.691
WV$314.151
WY$341.241

See 46922 in every payment locality

How the 46922 rate is calculated

Each of 46922’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 · 46922

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.86

1.86 RVUs× 1.000 GPCI

Practice expense8.09

8.09 RVUs× 1.000 GPCI

Malpractice0.36

0.36 RVUs× 1.000 GPCI

Adjusted RVUs

10.3100

Conversion factor

$33.4009

Medicare rate

$344.36

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,634

Code
46922
Physician work
1.86
Practice expense
8.09
Malpractice
0.36

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 46922 in North Carolina
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0001.8600
Practice expense8.09× 0.9337.5480
Malpractice0.36× 0.6390.2300
Total RVUs9.6380
Conversion factor× 33.4009

Office rate, North Carolina$321.92

Office: (1.86 × 1 + 8.09 × 0.933 + 0.36 × 0.639) × $33.4009 = $321.92

Facility: (1.86 × 1 + 1.8 × 0.933 + 0.36 × 0.639) × $33.4009 = $125.90

Open 46922 in the RVU calculator

Payment rules and modifiers for 46922

46922 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 46922

Anal lesion excision, one or more 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 · 46922

Anal lesion excision, one or more 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

46922 without 51 · national office

$344.36

Anal lesion excision, one or more lesions

46922-51 · Second procedure: 50%

$172.18

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 46922 has changed in North Carolina

46922 · Office / nonfacility

$321.92

Effective 2026-10-01

The base rate is $41.83 higher than on 2025-10-01, moving from $280.09 to $321.92 (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

    $280.09changed to$321.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.91 changed to 1.86
    • Practice expense RVU 7.03 changed to 8.09
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $292.56changed to$280.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.17 changed to 7.03

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $287.78changed to$292.56

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $300.64changed to$287.78

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.23 changed to 7.17
    • Malpractice RVU 0.35 changed to 0.36
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $310.17changed to$300.64

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.30 changed to 7.23
    • Malpractice RVU 0.34 changed to 0.35
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $306.27changed to$310.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.10 changed to 7.30

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $284.24changed to$306.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.13 changed to 7.10
    • Malpractice RVU 0.35 changed to 0.34
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $270.02changed to$284.24

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.72 changed to 6.13
    • Malpractice RVU 0.37 changed to 0.35
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $259.42changed to$270.02

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.42 changed to 5.72
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $256.69changed to$259.42

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.34 changed to 5.42
    • Malpractice RVU 0.37 changed to 0.36
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $256.04changed to$256.69

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.33 changed to 5.34
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $257.75changed to$256.04

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.37 changed to 5.33
    • Malpractice RVU 0.35 changed to 0.37

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $256.46changed to$257.75

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $253.46changed to$256.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.30 changed to 5.37
    • Malpractice RVU 0.33 changed to 0.35
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $261.55changed to$253.46

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.97 changed to 5.30
    • Malpractice RVU 0.35 changed to 0.33
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $261.55

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$321.92$125.90RVU26D
2026-07-01$321.92$125.90RVU26C
2026-04-01$321.92$125.90RVU26B
2026-01-01$321.92$125.90RVU26A
2025-10-01$280.09$127.33RVU25D
2025-07-01$280.09$127.33RVU25C
2025-04-01$280.09$127.33RVU25B
2025-01-01$280.09$127.33RVU25A
2024-10-01$292.56$130.11RVU24D
2024-07-01$292.56$130.11RVU24C
2024-04-01$292.56$130.11RVU24B
2024-03-09$292.56$130.11RVU24AR
2024-01-01$287.78$127.99RVU24A
2023-10-01$300.64$132.27RVU23D
2023-07-01$300.64$132.27RVU23C
2023-04-01$300.64$132.27RVU23B
2023-01-01$300.64$132.27RVU23A
2022-10-01$310.17$134.18RVU22D
2022-07-01$310.17$134.18RVU22C
2022-04-01$310.17$134.18RVU22B
2022-01-01$310.17$134.18RVU22A
2021-10-01$306.27$133.35RVU21D
2021-07-01$306.27$133.35RVU21C
2021-04-01$306.27$133.35RVU21B
2021-01-01$306.27$133.35RVU21A
2020-10-01$284.24$134.54RVU20D
2020-07-01$284.24$134.54RVU20C
2020-04-01$284.24$134.54RVU20B
2020-01-01$284.24$134.54RVU20A
2019-10-01$270.02$133.13RVU19D
2019-07-01$270.02$133.13RVU19C
2019-04-01$270.02$133.13RVU19B
2019-01-01$270.02$133.13RVU19A
2018-10-01$259.42$132.73RVU18D
2018-07-01$259.42$132.73RVU18C
2018-04-01$259.42$132.73RVU18B
2018-01-01$259.42$132.73RVU18AR1
2017-10-01$256.69$132.40RVU17D
2017-07-01$256.69$132.40RVU17C
2017-04-01$256.69$132.40RVU17B
2017-01-01$256.69$132.40RVU17A
2016-10-01$256.04$132.50RVU16D
2016-07-01$256.04$132.50RVU16C
2016-04-01$256.04$132.50RVU16B
2016-01-01$256.04$132.50RVU16A
2015-10-01$257.75$133.43RVU15D
2015-07-01$257.75$133.43RVU15C
2015-04-01$256.46$132.77RVU15B
2015-01-01$256.46$132.77RVU15A
2014-10-01$253.46$131.32RVU14D
2014-07-01$253.46$131.32RVU14C
2014-04-01$253.46$131.32RVU14B
2014-01-01$253.46$131.32RVU14A
2013-10-01$261.55$130.35RVU13D
2013-07-01$261.55$130.35RVU13C
2013-04-01$261.55$130.35RVU13B
2013-01-01$261.55$130.35RVU13AR

Price 46922 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

46922 billing questions

How is 46922 different from anal lesion destruction codes?

46922 is for surgical excision of the lesion. Destruction codes apply when the lesion is treated by an ablative method rather than cut out.

Should 46922 be reported once for each lesion?

The code covers excision of one or more anal lesions; do not assign a separate unit for each lesion. Document how many lesions were treated.

Are related postoperative visits separately payable during the global period?

Related postoperative visits within 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 procedure.

Can an assistant or co-surgeon be reported for 46922?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full; other procedures in that session are subject to the standard 50% multiple-procedure reduction.

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 46922PPRRVU2026_Oct_nonQPP.csv, line 5,634 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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