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

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 Houston, TX, Medicare pays $347.49 for 46922 in the office and $138.87 when it’s performed in a hospital or facility.

$347.49Office (non-facility)
$138.87Hospital or facility
+0.9%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $347.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

46922 in Houston, TX vs other payment areas
  1. Houston, TX · this page$347.49
  2. Austin, TX · Texas$358.79+$11.30
  3. Beaumont, TX · Texas$319.19−$28.30
  4. Brazoria, TX · Texas$339.78−$7.71
  5. Dallas, TX · Texas$342.13−$5.36
  6. Fort Worth, TX · Texas$339.59−$7.90
  7. Galveston, TX · Texas$340.90−$6.59

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

Every other payment area

46922 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$329.42$130.04
Los Angeles, CACalifornia$392.32$143.78
Washington, DC areaDistrict of Columbia$397.17$149.69
Miami, FLFlorida$373.83$155.12
Chicago, ILIllinois$361.72$150.58
Manhattan, NYNew York$399.16$155.03
AlaskaAlaska$387.59$163.84
AlabamaAlabama$305.37$121.54

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 46922 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.86× 1.0081.8749
Practice expense8.09× 0.9938.0334
Malpractice0.36× 1.3760.4954
Total RVUs10.4036
Conversion factor× 33.4009

Office rate, Houston, TX$347.49

Office: (1.86 × 1.008 + 8.09 × 0.993 + 0.36 × 1.376) × $33.4009 = $347.49

Facility: (1.86 × 1.008 + 1.8 × 0.993 + 0.36 × 1.376) × $33.4009 = $138.87

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, Houston, TX
Used instead
46900Anal lesion destruction, simple lesionsAnal lesion destruction by a simple method, rather than surgical excision.$270.92
46910Anal lesion destruction, extensive lesionsAnal lesion destruction classified as extensive, rather than surgical excision.$299.29
46916Anal lesion treatment, cryosurgery, simple lesionsAnal lesions treated with cryosurgery rather than excision.$255.89
46917Anal lesion laser, simple, laser surgeryAnal lesions treated with laser surgery rather than excision.$465.66
46924Anal lesion destruction, extensive treatmentExtensive anal lesion destruction rather than surgical excision.$624.11

How 46922 has changed in Houston, TX

46922 · Office / nonfacility

$347.49

Effective 2026-10-01

The base rate is $40.36 higher than on 2025-10-01, moving from $307.13 to $347.49 (13.1%).

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

    $307.13changed to$347.49

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $320.74changed to$307.13

    • 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

    $315.51changed to$320.74

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $328.82changed to$315.51

    • 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
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $338.75changed to$328.82

    • 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 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $334.38changed to$338.75

    • 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

    $307.97changed to$334.38

    • 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 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $291.31changed to$307.97

    • 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 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $279.72changed to$291.31

    • 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

    $275.85changed to$279.72

    • 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
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $274.32changed to$275.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.33 changed to 5.34
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $276.07changed to$274.32

    • 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

    $274.69changed to$276.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $271.10changed to$274.69

    • 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 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $280.08changed to$271.10

    • 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 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $280.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$347.49$138.87RVU26D
2026-07-01$347.49$138.87RVU26C
2026-04-01$347.49$138.87RVU26B
2026-01-01$347.49$138.87RVU26A
2025-10-01$307.13$141.67RVU25D
2025-07-01$307.13$141.67RVU25C
2025-04-01$307.13$141.67RVU25B
2025-01-01$307.13$141.67RVU25A
2024-10-01$320.74$144.79RVU24D
2024-07-01$320.74$144.79RVU24C
2024-04-01$320.74$144.79RVU24B
2024-03-09$320.74$144.79RVU24AR
2024-01-01$315.51$142.43RVU24A
2023-10-01$328.82$144.28RVU23D
2023-07-01$328.82$144.28RVU23C
2023-04-01$328.82$144.28RVU23B
2023-01-01$328.82$144.28RVU23A
2022-10-01$338.75$143.61RVU22D
2022-07-01$338.75$143.61RVU22C
2022-04-01$338.75$143.61RVU22B
2022-01-01$338.75$143.61RVU22A
2021-10-01$334.38$142.65RVU21D
2021-07-01$334.38$142.65RVU21C
2021-04-01$334.38$142.65RVU21B
2021-01-01$334.38$142.65RVU21A
2020-10-01$307.97$143.79RVU20D
2020-07-01$307.97$143.79RVU20C
2020-04-01$307.97$143.79RVU20B
2020-01-01$307.97$143.79RVU20A
2019-10-01$291.31$142.51RVU19D
2019-07-01$291.31$142.51RVU19C
2019-04-01$291.31$142.51RVU19B
2019-01-01$291.31$142.51RVU19A
2018-10-01$279.72$142.01RVU18D
2018-07-01$279.72$142.01RVU18C
2018-04-01$279.72$142.01RVU18B
2018-01-01$279.72$142.01RVU18AR1
2017-10-01$275.85$141.14RVU17D
2017-07-01$275.85$141.14RVU17C
2017-04-01$275.85$141.14RVU17B
2017-01-01$275.85$141.14RVU17A
2016-10-01$274.32$140.69RVU16D
2016-07-01$274.32$140.69RVU16C
2016-04-01$274.32$140.69RVU16B
2016-01-01$274.32$140.69RVU16A
2015-10-01$276.07$141.59RVU15D
2015-07-01$276.07$141.59RVU15C
2015-04-01$274.69$140.89RVU15B
2015-01-01$274.69$140.89RVU15A
2014-10-01$271.10$139.10RVU14D
2014-07-01$271.10$139.10RVU14C
2014-04-01$271.10$139.10RVU14B
2014-01-01$271.10$139.10RVU14A
2013-10-01$280.08$138.26RVU13D
2013-07-01$280.08$138.26RVU13C
2013-04-01$280.08$138.26RVU13B
2013-01-01$280.08$138.26RVU13AR

Price 46922 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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