Billing code 46917: Anal lesion laserMedicare rate & RVUs
Reports simple laser destruction of anal lesions, such as condylomata, when laser energy is used instead of another destruction method or excision.
Medicare pays $464.27 for 46917 nationally in the office and $120.91 in a hospital or facility. Local office rates run $404.24–$640.08.
Medicare rate · 46917
Anal lesion laser
Swap in your local Medicare rate.
- Work RVUs
- 1.86
- Total RVUs
- 13.90
- Global days
- 010
National rate · 2026
$464.27
Office setting, before claim adjustments.
See every locality for 46917 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
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.
Where 46917 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$404.24 to $640.08
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $411.01 | $110.57 |
| Alaska* | $516.50 | $150.82 |
| Arizona | $450.71 | $117.99 |
| Arkansas | $404.24 | $109.29 |
| Atlanta | $472.69 | $123.83 |
| Austin | $486.06 | $122.78 |
| Bakersfield | $499.34 | $123.02 |
| Baltimore/Surr. Cntys | $496.21 | $127.79 |
| Beaumont | $428.26 | $115.80 |
| Brazoria | $459.11 | $118.84 |
| Chicago | $479.21 | $134.14 |
| Chico | $498.51 | $122.19 |
| Colorado | $488.01 | $122.68 |
| Connecticut | $497.77 | $127.97 |
| Dallas | $461.89 | $119.90 |
| Dc + Md/Va Suburbs | $538.58 | $134.10 |
| Delaware | $458.90 | $119.65 |
| Detroit | $457.18 | $125.84 |
| East St. Louis | $442.70 | $126.81 |
| El Centro | $498.56 | $122.23 |
| Fort Lauderdale | $477.20 | $129.38 |
| Fort Worth | $458.09 | $119.53 |
| Fresno | $498.51 | $122.19 |
| Galveston | $460.36 | $119.40 |
| Hanford-Corcoran | $498.51 | $122.19 |
| Hawaii, Guam | $513.96 | $123.56 |
| Houston | $465.66 | $124.71 |
| Idaho | $427.77 | $111.88 |
| Indiana | $430.64 | $112.35 |
| Iowa | $425.07 | $110.90 |
| Kansas | $421.79 | $111.39 |
| Kentucky | $419.89 | $114.64 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $535.39 | $129.19 |
| Madera | $498.51 | $122.19 |
| Manhattan | $537.50 | $138.52 |
| Merced | $498.51 | $122.19 |
| Metropolitan Boston | $541.89 | $131.92 |
| Metropolitan Kansas City | $440.11 | $117.69 |
| Metropolitan Philadelphia | $483.35 | $125.91 |
| Metropolitan St. Louis | $445.45 | $118.57 |
| Miami | $495.17 | $137.73 |
| Minnesota | $468.83 | $115.52 |
| Mississippi | $407.19 | $111.56 |
| Modesto | $498.51 | $122.19 |
| Montana** | $464.25 | $120.89 |
| Napa | $588.22 | $135.67 |
| Nebraska | $428.03 | $111.11 |
| Nevada** | $463.05 | $119.34 |
| New Hampshire | $479.15 | $121.71 |
| New Mexico | $433.65 | $118.78 |
| New Orleans | $442.43 | $119.33 |
| North Carolina | $434.48 | $114.12 |
| North Dakota** | $458.52 | $115.16 |
| Northern Nj | $531.64 | $133.34 |
| Nyc Suburbs/Long Island | $550.72 | $142.47 |
| Ohio | $430.21 | $116.72 |
| Oklahoma | $420.12 | $113.50 |
| Oxnard-Thousand Oaks-Ventura | $533.79 | $127.94 |
| Portland | $506.35 | $124.88 |
| Poughkpsie/N Nyc Suburbs | $506.39 | $130.41 |
| Puerto Rico | $468.44 | $121.31 |
| Queens | $543.96 | $138.10 |
| Redding | $498.51 | $122.19 |
| Rest Of California | $498.51 | $122.19 |
| Rest Of Florida | $451.88 | $123.62 |
| Rest Of Georgia | $423.75 | $117.47 |
| Rest Of Illinois | $435.58 | $122.09 |
| Rest Of Louisiana | $418.73 | $114.86 |
| Rest Of Maine | $429.21 | $113.32 |
| Rest Of Maryland | $468.81 | $121.33 |
| Rest Of Massachusetts | $484.10 | $122.54 |
| Rest Of Michigan | $431.38 | $117.89 |
| Rest Of Missouri | $409.86 | $113.88 |
| Rest Of New Jersey | $503.80 | $128.85 |
| Rest Of New York | $441.77 | $115.58 |
| Rest Of Oregon | $459.83 | $117.84 |
| Rest Of Pennsylvania | $431.56 | $116.35 |
| Rest Of Texas | $443.32 | $117.47 |
| Rest Of Washington | $483.57 | $122.01 |
| Rhode Island | $477.36 | $122.67 |
| Riverside-San Bernardino-Ontario | $501.64 | $125.32 |
| Sacramento-Roseville-Folsom | $525.99 | $126.66 |
| Salinas | $524.11 | $126.15 |
| San Diego-Chula Vista-Carlsbad | $538.62 | $127.96 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $625.84 | $141.70 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $625.51 | $141.37 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $640.08 | $144.95 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $638.73 | $143.61 |
| San Luis Obispo-Paso Robles | $515.39 | $124.30 |
| Santa Cruz-Watsonville | $545.46 | $128.28 |
| Santa Maria-Santa Barbara | $526.67 | $126.31 |
| Santa Rosa-Petaluma | $551.12 | $129.48 |
| Seattle (King Cnty) | $554.69 | $133.39 |
| South Carolina | $432.99 | $115.73 |
| South Dakota** | $457.84 | $114.48 |
| Southern Maine | $457.17 | $116.90 |
| Stockton | $498.51 | $122.19 |
| Suburban Chicago | $482.78 | $130.15 |
| Tennessee | $424.07 | $111.96 |
| Utah | $439.74 | $116.98 |
| Vallejo | $587.75 | $135.20 |
| Vermont | $455.56 | $115.64 |
| Virgin Islands | $468.44 | $121.31 |
| Virginia | $454.75 | $117.23 |
| Visalia | $498.51 | $122.19 |
| West Virginia | $417.03 | $118.65 |
| Wisconsin | $441.09 | $112.15 |
| Wyoming** | $461.75 | $118.39 |
| Yuba City | $498.51 | $122.19 |
46917 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.
$404.24
$569.30
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $516.50 | 1 |
| AL | $411.01 | 1 |
| AR | $404.24 | 1 |
| AZ | $450.71 | 1 |
| CA | $498.51–$640.08 | 29 |
| CO | $488.01 | 1 |
| CT | $497.77 | 1 |
| DC | $538.58 | 1 |
| DE | $458.90 | 1 |
| FL | $451.88–$495.17 | 3 |
| GA | $423.75–$472.69 | 2 |
| GU | $513.96 | 1 |
| HI | $513.96 | 1 |
| IA | $425.07 | 1 |
| ID | $427.77 | 1 |
| IL | $435.58–$482.78 | 4 |
| IN | $430.64 | 1 |
| KS | $421.79 | 1 |
| KY | $419.89 | 1 |
| LA | $418.73–$442.43 | 2 |
| MA | $484.10–$541.89 | 2 |
| MD | $468.81–$538.58 | 3 |
| ME | $429.21–$457.17 | 2 |
| MI | $431.38–$457.18 | 2 |
| MN | $468.83 | 1 |
| MO | $409.86–$445.45 | 3 |
| MS | $407.19 | 1 |
| MT | $464.25 | 1 |
| NC | $434.48 | 1 |
| ND | $458.52 | 1 |
| NE | $428.03 | 1 |
| NH | $479.15 | 1 |
| NJ | $503.80–$531.64 | 2 |
| NM | $433.65 | 1 |
| NV | $463.05 | 1 |
| NY | $441.77–$550.72 | 5 |
| OH | $430.21 | 1 |
| OK | $420.12 | 1 |
| OR | $459.83–$506.35 | 2 |
| PA | $431.56–$483.35 | 2 |
| PR | $468.44 | 1 |
| RI | $477.36 | 1 |
| SC | $432.99 | 1 |
| SD | $457.84 | 1 |
| TN | $424.07 | 1 |
| TX | $428.26–$486.06 | 8 |
| UT | $439.74 | 1 |
| VA | $454.75–$538.58 | 2 |
| VI | $468.44 | 1 |
| VT | $455.56 | 1 |
| WA | $483.57–$554.69 | 2 |
| WI | $441.09 | 1 |
| WV | $417.03 | 1 |
| WY | $461.75 | 1 |
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
Swap in your local Medicare rate.
Work 1.86Practice expense 11.75Malpractice 0.29
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 46917
Anal lesion laser
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.
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
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%).
46917 compared with similar codes
Compare codes
46917 vs 46916 vs 46924 vs 46922: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46916Anal lesion treatment
- Choose 46917 for simple laser destruction and 46916 for simple cryosurgical destruction. The treatment method documented in the procedure note separates the codes.
- 46924Anal lesion destruction
- 46917 describes simple laser destruction; 46924 is for extensive destruction of anal lesions. Base the distinction on documented treatment extent.
- 46922Anal lesion excision
- 46922 is used when anal lesions are excised. Use 46917 when the lesions are destroyed with laser energy instead of being removed.
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
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