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

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 Nevada, Medicare pays $342.63 for 46922 in the office and $132.32 when it’s performed in a hospital or facility.

$342.63Office (non-facility)
$132.32Hospital or facility
−0.5%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 Nevada
  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 Nevada 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. Nevada pays $342.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

46922 in Nevada vs other payment areas
  1. Nevada · this page$342.63
  2. Los Angeles, CA · California$392.32+$49.69
  3. Washington, DC area · District of Columbia$397.17+$54.54
  4. Miami, FL · Florida$373.83+$31.20
  5. Chicago, IL · Illinois$361.72+$19.09
  6. Manhattan, NY · New York$399.16+$56.53
  7. Alaska · Alaska$387.59+$44.96

Other areas in Nevada 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.

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.

$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 Nevada 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

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 46922 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0001.8600
Practice expense8.09× 1.0018.0981
Malpractice0.36× 0.8330.2999
Total RVUs10.2580
Conversion factor× 33.4009

Office rate, Nevada$342.63

Office: (1.86 × 1 + 8.09 × 1.001 + 0.36 × 0.833) × $33.4009 = $342.63

Facility: (1.86 × 1 + 1.8 × 1.001 + 0.36 × 0.833) × $33.4009 = $132.32

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

Codes related to 46922

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

Codes related to 46922
CodeHow it relatesOffice range, Nevada
Used instead
46900Anal lesion destruction, simple lesionsAnal lesion destruction by a simple method, rather than surgical excision.$267.29
46910Anal lesion destruction, extensive lesionsAnal lesion destruction classified as extensive, rather than surgical excision.$295.15
46916Anal lesion treatment, cryosurgery, simple lesionsAnal lesions treated with cryosurgery rather than excision.$253.25
46917Anal lesion laser, simple, laser surgeryAnal lesions treated with laser surgery rather than excision.$463.05
46924Anal lesion destruction, extensive treatmentExtensive anal lesion destruction rather than surgical excision.$619.71

How 46922 has changed in Nevada

46922 · Office / nonfacility

$342.63

Effective 2026-10-01

The base rate is $43.62 higher than on 2025-10-01, moving from $299.01 to $342.63 (14.6%).

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

    $299.01changed to$342.63

    • 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 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $312.36changed to$299.01

    • 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

    $307.27changed to$312.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $322.75changed to$307.27

    • 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
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $334.95changed to$322.75

    • 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
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $330.75changed to$334.95

    • 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

    $304.71changed to$330.75

    • 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
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $290.74changed to$304.71

    • 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
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $279.11changed to$290.74

    • 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

    $279.54changed to$279.11

    • 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
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $282.31changed to$279.54

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.33 changed to 5.34
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $284.13changed to$282.31

    • 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

    $282.72changed to$284.13

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $281.88changed to$282.72

    • 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
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $294.55changed to$281.88

    • 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
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$294.55

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$342.63$132.32RVU26D
2026-07-01$342.63$132.32RVU26C
2026-04-01$342.63$132.32RVU26B
2026-01-01$342.63$132.32RVU26A
2025-10-01$299.01$134.04RVU25D
2025-07-01$299.01$134.04RVU25C
2025-04-01$299.01$134.04RVU25B
2025-01-01$299.01$134.04RVU25A
2024-10-01$312.36$136.94RVU24D
2024-07-01$312.36$136.94RVU24C
2024-04-01$312.36$136.94RVU24B
2024-03-09$312.36$136.94RVU24AR
2024-01-01$307.27$134.70RVU24A
2023-10-01$322.75$141.12RVU23D
2023-07-01$322.75$141.12RVU23C
2023-04-01$322.75$141.12RVU23B
2023-01-01$322.75$141.12RVU23A
2022-10-01$334.95$145.31RVU22D
2022-07-01$334.95$145.31RVU22C
2022-04-01$334.95$145.31RVU22B
2022-01-01$334.95$145.31RVU22A
2021-10-01$330.75$144.42RVU21D
2021-07-01$330.75$144.42RVU21C
2021-04-01$330.75$144.42RVU21B
2021-01-01$330.75$144.42RVU21A
2020-10-01$304.71$143.75RVU20D
2020-07-01$304.71$143.75RVU20C
2020-04-01$304.71$143.75RVU20B
2020-01-01$304.71$143.75RVU20A
2019-10-01$290.74$141.20RVU19D
2019-07-01$290.74$141.20RVU19C
2019-04-01$290.74$141.20RVU19B
2019-01-01$290.74$141.20RVU19A
2018-10-01$279.11$140.72RVU18D
2018-07-01$279.11$140.72RVU18C
2018-04-01$279.11$140.72RVU18B
2018-01-01$279.11$140.72RVU18AR1
2017-10-01$279.54$141.50RVU17D
2017-07-01$279.54$141.50RVU17C
2017-04-01$279.54$141.50RVU17B
2017-01-01$279.54$141.50RVU17A
2016-10-01$282.31$142.70RVU16D
2016-07-01$282.31$142.70RVU16C
2016-04-01$282.31$142.70RVU16B
2016-01-01$282.31$142.70RVU16A
2015-10-01$284.13$143.64RVU15D
2015-07-01$284.13$143.64RVU15C
2015-04-01$282.72$142.93RVU15B
2015-01-01$282.72$142.93RVU15A
2014-10-01$281.88$143.18RVU14D
2014-07-01$281.88$143.18RVU14C
2014-04-01$281.88$143.18RVU14B
2014-01-01$281.88$143.18RVU14A
2013-10-01$294.55$144.81RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46922 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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 NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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