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

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 South Dakota, Medicare pays $336.38 for 46922 in the office and $126.29 when it’s performed in a hospital or facility.

$336.38Office (non-facility)
$126.29Hospital or facility
−2.3%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 South Dakota
  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 South Dakota 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. South Dakota pays $336.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

46922 in South Dakota vs other payment areas
  1. South Dakota · this page$336.38
  2. Los Angeles, CA · California$392.32+$55.94
  3. Washington, DC area · District of Columbia$397.17+$60.79
  4. Miami, FL · Florida$373.83+$37.45
  5. Chicago, IL · Illinois$361.72+$25.34
  6. Manhattan, NY · New York$399.16+$62.78
  7. Alaska · Alaska$387.59+$51.21

Other areas in South Dakota 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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 46922 in South Dakota
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0001.8600
Practice expense8.09× 1.0008.0900
Malpractice0.36× 0.3360.1210
Total RVUs10.0710
Conversion factor× 33.4009

Office rate, South Dakota$336.38

Office: (1.86 × 1 + 8.09 × 1 + 0.36 × 0.336) × $33.4009 = $336.38

Facility: (1.86 × 1 + 1.8 × 1 + 0.36 × 0.336) × $33.4009 = $126.29

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 South Dakota

46922 · Office / nonfacility

$336.38

Effective 2026-10-01

The base rate is $42.75 higher than on 2025-10-01, moving from $293.63 to $336.38 (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

    $293.63changed to$336.38

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $306.83changed to$293.63

    • 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

    $301.82changed to$306.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $314.05changed to$301.82

    • 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 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $322.81changed to$314.05

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $318.50changed to$322.81

    • 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

    $294.81changed to$318.50

    • 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
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $280.17changed to$294.81

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $268.92changed to$280.17

    • 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

    $265.44changed to$268.92

    • 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 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $264.52changed to$265.44

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.33 changed to 5.34
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $266.63changed to$264.52

    • 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

    $265.30changed to$266.63

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $263.20changed to$265.30

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $273.25changed to$263.20

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $273.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$336.38$126.29RVU26D
2026-07-01$336.38$126.29RVU26C
2026-04-01$336.38$126.29RVU26B
2026-01-01$336.38$126.29RVU26A
2025-10-01$293.63$128.66RVU25D
2025-07-01$293.63$128.66RVU25C
2025-04-01$293.63$128.66RVU25B
2025-01-01$293.63$128.66RVU25A
2024-10-01$306.83$131.40RVU24D
2024-07-01$306.83$131.40RVU24C
2024-04-01$306.83$131.40RVU24B
2024-03-09$306.83$131.40RVU24AR
2024-01-01$301.82$129.26RVU24A
2023-10-01$314.05$132.41RVU23D
2023-07-01$314.05$132.41RVU23C
2023-04-01$314.05$132.41RVU23B
2023-01-01$314.05$132.41RVU23A
2022-10-01$322.81$133.16RVU22D
2022-07-01$322.81$133.16RVU22C
2022-04-01$322.81$133.16RVU22B
2022-01-01$322.81$133.16RVU22A
2021-10-01$318.50$132.17RVU21D
2021-07-01$318.50$132.17RVU21C
2021-04-01$318.50$132.17RVU21B
2021-01-01$318.50$132.17RVU21A
2020-10-01$294.81$133.85RVU20D
2020-07-01$294.81$133.85RVU20C
2020-04-01$294.81$133.85RVU20B
2020-01-01$294.81$133.85RVU20A
2019-10-01$280.17$133.13RVU19D
2019-07-01$280.17$133.13RVU19C
2019-04-01$280.17$133.13RVU19B
2019-01-01$280.17$133.13RVU19A
2018-10-01$268.92$132.84RVU18D
2018-07-01$268.92$132.84RVU18C
2018-04-01$268.92$132.84RVU18B
2018-01-01$268.92$132.84RVU18AR1
2017-10-01$265.44$131.93RVU17D
2017-07-01$265.44$131.93RVU17C
2017-04-01$265.44$131.93RVU17B
2017-01-01$265.44$131.93RVU17A
2016-10-01$264.52$131.69RVU16D
2016-07-01$264.52$131.69RVU16C
2016-04-01$264.52$131.69RVU16B
2016-01-01$264.52$131.69RVU16A
2015-10-01$266.63$132.95RVU15D
2015-07-01$266.63$132.95RVU15C
2015-04-01$265.30$132.29RVU15B
2015-01-01$265.30$132.29RVU15A
2014-10-01$263.20$131.73RVU14D
2014-07-01$263.20$131.73RVU14C
2014-04-01$263.20$131.73RVU14B
2014-01-01$263.20$131.73RVU14A
2013-10-01$273.25$131.71RVU13D
2013-07-01$273.25$131.71RVU13C
2013-04-01$273.25$131.71RVU13B
2013-01-01$273.25$131.71RVU13AR

Price 46922 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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