Billing code 46942: Anal fissure treatmentMedicare rate & RVUs

Medicare pays $277.90 for 46942 nationally in the office and $123.58 in a hospital or facility. Local office rates run $244.89–$369.55.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 46942 covers

Code 46942 represents a subsequent procedural treatment directed at an anal fissure. It is used by clinicians such as colorectal surgeons and general surgeons when the fissure requires further active treatment after an initial treatment. The service addresses the fissure itself; it is not simply an office assessment of persistent pain, bleeding, or healing. A routine follow-up visit within the postoperative period is included in the original procedure’s global care.

Choose this code when documentation supports subsequent treatment, not the initial fissure treatment reported with 46940. The record should identify the fissure and explain the further treatment performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 46942 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

46942 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 46942 rate is calculated

Each of 46942’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.

Payment rules and modifiers for 46942

46942 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

46942 compared with similar codes

How to choose

46940Anal fissure treatment

Use 46940 for initial anal fissure treatment and 46942 for subsequent treatment. The treatment stage, not simply a follow-up date, distinguishes them.

46080Anal sphincterotomy

46080 identifies an incision of the anal sphincter for fissure treatment. Use it when that specific procedure is performed, rather than selecting 46942 solely because a fissure is present.

46505Anal chemodenervation

46505 describes injection into the anal sphincter. It represents an injection procedure, not subsequent fissure treatment as coded by 46942.

Codes related to 46942

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

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

Open CMS sourceHow we calculate rates