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CMS RVU26D · Effective 2026-10-01

46230 in Wyoming**

Office / nonfacility

$338.19

Base rate per service

Facility setting

$162.17

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Anorectal surgery

About 46230: Excision of multiple anal tags

Excision of multiple anal skin tags is reported when a clinician surgically removes more than one symptomatic tag from the anal area.

This procedure removes multiple external anal skin tags, which are folds of skin that may cause irritation or make hygiene difficult. A colorectal surgeon or other qualified clinician typically performs the excision in an office or outpatient surgical setting, using local or other appropriate anesthesia. The operative work is directed at the tags themselves, rather than removal of hemorrhoidal tissue or treatment of a fissure.

Report 46230 when multiple anal tags are excised; the operative note should identify the tags removed and document the procedure performed. A single anal papilla or tag is represented by the related single-tag code, 46220. The service has 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 the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 46230

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.55 · 25%
  • Practice expense (office) RVU7.22 · 70%
  • Malpractice RVU0.48 · 5%

973

Medicare services in 2024 · #2991 by national volume

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.

46230 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

46220

Anal tag excision

Single external tag

$273.04

46220 represents excision of a single anal papilla or tag; 46230 is for multiple anal tags.

46250

Hemorrhoidectomy

External, two or more groups

$529.46

46250 is for excision of multiple external hemorrhoid groups. Choose 46230 when the excised tissue consists of multiple anal skin tags.

46255

Hemorrhoidectomy

One internal and external group

$572.94

46255 applies to excision of one internal and external hemorrhoid group, rather than multiple anal skin tags.

The same code, a different location

How does Wyoming** compare?

46230 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $338.19

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $384.60

    $46.41 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $391.70

    $53.51 higher than Wyoming**

  4. Miami

    $376.76

    $38.57 higher than Wyoming**

  5. Chicago

    $364.92

    $26.73 higher than Wyoming**

  6. Manhattan

    $396.27

    $58.08 higher than Wyoming**

  7. Alaska*

    $393.42

    $55.23 higher than Wyoming**

Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 46230 ranges from $300.58 in Arkansas to $450.88 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 46230

    Office

    $305.26

    Facility

    $151.24

    $32.93 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 46230

    Office

    $300.58

    Facility

    $149.38

    $37.61 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 46230

    Office

    $332.57

    Facility

    $162.01

    $5.62 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 46230

    Office

    $360.86

    Facility

    $167.94

    $22.67 higher than Wyoming** for the office setting.

  • Chico

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • El Centro

    California · 46230

    Office

    $359.60

    Facility

    $166.68

    $21.41 higher than Wyoming** for the office setting.

  • Fresno

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Madera

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Merced

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Modesto

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Napa

    California · 46230

    Office

    $416.52

    Facility

    $184.53

    $78.33 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 46230

    Office

    $382.59

    Facility

    $174.53

    $44.40 higher than Wyoming** for the office setting.

  • Redding

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 46230

    Office

    $364.69

    Facility

    $171.77

    $26.50 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 46230

    Office

    $377.29

    Facility

    $172.58

    $39.10 higher than Wyoming** for the office setting.

  • Salinas

    California · 46230

    Office

    $375.90

    Facility

    $171.89

    $37.71 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 46230

    Office

    $384.84

    Facility

    $174.31

    $46.65 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 46230

    Office

    $440.65

    Facility

    $192.46

    $102.46 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 46230

    Office

    $440.11

    Facility

    $191.91

    $101.92 higher than Wyoming** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 46230

    Office

    $450.88

    Facility

    $197.05

    $112.69 higher than Wyoming** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 46230

    Office

    $448.65

    Facility

    $194.83

    $110.46 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 46230

    Office

    $369.89

    Facility

    $169.40

    $31.70 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 46230

    Office

    $388.56

    Facility

    $174.69

    $50.37 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 46230

    Office

    $377.34

    Facility

    $172.09

    $39.15 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 46230

    Office

    $392.46

    Facility

    $176.30

    $54.27 higher than Wyoming** for the office setting.

  • Stockton

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Vallejo

    California · 46230

    Office

    $415.74

    Facility

    $183.74

    $77.55 higher than Wyoming** for the office setting.

  • Visalia

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Yuba City

    California · 46230

    Office

    $359.52

    Facility

    $166.60

    $21.33 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 46230

    Office

    $355.30

    Facility

    $168.02

    $17.11 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 46230

    Office

    $366.00

    Facility

    $176.42

    $27.81 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 46230

    Office

    $338.27

    Facility

    $164.36

    $0.08 higher than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 46230

    Office

    $358.45

    Facility

    $180.14

    $20.26 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 46230

    Office

    $339.81

    Facility

    $171.53

    $1.62 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 46230

    Office

    $349.70

    Facility

    $170.86

    $11.51 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 46230

    Office

    $319.39

    Facility

    $162.38

    $18.80 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 46230

    Office

    $368.65

    Facility

    $168.51

    $30.46 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 46230

    Office

    $312.19

    Facility

    $151.13

    $26.00 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 46230

    Office

    $314.62

    Facility

    $152.68

    $23.57 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 46230

    Office

    $339.32

    Facility

    $177.38

    $1.13 higher than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 46230

    Office

    $330.41

    Facility

    $169.70

    $7.78 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 46230

    Office

    $361.84

    Facility

    $181.07

    $23.65 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 46230

    Office

    $316.51

    Facility

    $153.34

    $21.68 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 46230

    Office

    $311.26

    Facility

    $152.13

    $26.93 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 46230

    Office

    $314.23

    Facility

    $157.74

    $23.96 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 46230

    Office

    $330.31

    Facility

    $164.67

    $7.88 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 46230

    Office

    $313.95

    Facility

    $158.17

    $24.24 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 46230

    Office

    $390.87

    Facility

    $180.70

    $52.68 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 46230

    Office

    $353.25

    Facility

    $167.90

    $15.06 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 46230

    Office

    $365.13

    Facility

    $176.25

    $26.94 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 46230

    Office

    $344.79

    Facility

    $166.66

    $6.60 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 46230

    Office

    $317.01

    Facility

    $155.07

    $21.18 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 46230

    Office

    $334.27

    Facility

    $159.83

    $3.92 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 46230

    Office

    $344.92

    Facility

    $175.06

    $6.73 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 46230

    Office

    $323.45

    Facility

    $162.74

    $14.74 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 46230

    Office

    $338.07

    Facility

    $156.94

    $0.12 lower than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 46230

    Office

    $327.28

    Facility

    $161.99

    $10.91 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 46230

    Office

    $330.82

    Facility

    $163.24

    $7.37 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 46230

    Office

    $308.66

    Facility

    $156.93

    $29.53 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 46230

    Office

    $304.65

    Facility

    $153.10

    $33.54 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 46230

    Office

    $342.33

    Facility

    $166.30

    $4.14 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 46230

    Office

    $320.41

    Facility

    $156.18

    $17.78 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 46230

    Office

    $332.84

    Facility

    $156.81

    $5.35 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 46230

    Office

    $313.82

    Facility

    $151.35

    $24.37 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 46230

    Office

    $350.24

    Facility

    $167.00

    $12.05 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 46230

    Office

    $387.40

    Facility

    $183.21

    $49.21 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 46230

    Office

    $369.51

    Facility

    $177.29

    $31.32 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 46230

    Office

    $325.57

    Facility

    $164.15

    $12.62 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 46230

    Office

    $339.92

    Facility

    $163.72

    $1.73 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 46230

    Office

    $407.13

    Facility

    $197.84

    $68.94 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 46230

    Office

    $372.47

    Facility

    $179.72

    $34.28 higher than Wyoming** for the office setting.

  • Queens

    New York · 46230

    Office

    $398.79

    Facility

    $190.73

    $60.60 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 46230

    Office

    $325.54

    Facility

    $158.32

    $12.65 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 46230

    Office

    $321.51

    Facility

    $160.80

    $16.68 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 46230

    Office

    $312.98

    Facility

    $155.79

    $25.21 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 46230

    Office

    $366.39

    Facility

    $170.82

    $28.20 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 46230

    Office

    $336.63

    Facility

    $161.31

    $1.56 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 46230

    Office

    $356.87

    Facility

    $173.63

    $18.68 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 46230

    Office

    $321.70

    Facility

    $160.11

    $16.49 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 46230

    Office

    $344.77

    Facility

    $166.81

    $6.58 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 46230

    Office

    $350.20

    Facility

    $168.37

    $12.01 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 46230

    Office

    $321.63

    Facility

    $158.98

    $16.56 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 46230

    Office

    $331.71

    Facility

    $155.69

    $6.48 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 46230

    Office

    $312.99

    Facility

    $152.99

    $25.20 lower than Wyoming** for the office setting.

  • Austin

    Texas · 46230

    Office

    $354.69

    Facility

    $168.46

    $16.50 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 46230

    Office

    $319.52

    Facility

    $159.34

    $18.67 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 46230

    Office

    $337.34

    Facility

    $162.90

    $0.85 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 46230

    Office

    $339.88

    Facility

    $164.57

    $1.69 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 46230

    Office

    $337.68

    Facility

    $164.12

    $0.51 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 46230

    Office

    $338.59

    Facility

    $163.80

    $0.40 higher than Wyoming** for the office setting.

  • Houston

    Texas · 46230

    Office

    $347.38

    Facility

    $172.59

    $9.19 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 46230

    Office

    $328.51

    Facility

    $161.46

    $9.68 lower than Wyoming** for the office setting.

  • Utah

    Utah · 46230

    Office

    $326.25

    Facility

    $160.79

    $11.94 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 46230

    Office

    $333.55

    Facility

    $160.52

    $4.64 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 46230

    Office

    $344.77

    Facility

    $166.81

    $6.58 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 46230

    Office

    $332.03

    Facility

    $157.77

    $6.16 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 46230

    Office

    $352.42

    Facility

    $167.06

    $14.23 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 46230

    Office

    $398.43

    Facility

    $182.45

    $60.24 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 46230

    Office

    $321.14

    Facility

    $152.51

    $17.05 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 46230

    Office

    $317.68

    Facility

    $164.71

    $20.51 lower than Wyoming** for the office setting.

See how rates vary across the country

46230 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$300.58

$405.20

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$393.421
AL$305.261
AR$300.581
AZ$332.571
CA$359.52–$450.8829
CO$355.301
CT$366.001
DC$391.701
DE$338.271
FL$339.81–$376.763
GA$319.39–$349.702
GU$368.651
HI$368.651
IA$312.191
ID$314.621
IL$330.41–$364.924
IN$316.511
KS$311.261
KY$314.231
LA$313.95–$330.312
MA$353.25–$390.872
MD$344.79–$391.703
ME$317.01–$334.272
MI$323.45–$344.922
MN$338.071
MO$308.66–$330.823
MS$304.651
MT$342.331
NC$320.411
ND$332.841
NE$313.821
NH$350.241
NJ$369.51–$387.402
NM$325.571
NV$339.921
NY$325.54–$407.135
OH$321.511
OK$312.981
OR$336.63–$366.392
PA$321.70–$356.872
PR$344.771
RI$350.201
SC$321.631
SD$331.711
TN$312.991
TX$319.52–$354.698
UT$326.251
VA$333.55–$391.702
VI$344.771
VT$332.031
WA$352.42–$398.432
WI$321.141
WV$317.681
WY$338.191

Explore 46230 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Wyoming →

Why are the office and facility amounts different?

For 46230 in Wyoming**, the physician’s office rate is $338.19 and the facility-setting rate is $162.17: a difference of $176.02.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 46230 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$372.01

$338.19 × 110% = $372.01

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 46230 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

5,582

Code
46230
Physician work
2.55
Practice expense
7.22
Malpractice
0.48

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 46230 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work2.55× 1.0002.5500
Practice expense7.22× 1.0007.2200
Malpractice0.48× 0.7400.3552
Total RVUs10.1252
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$338.19

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 46230 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.551
Practice expense7.221
Malpractice0.480.74

(2.55 × 1 + 7.22 × 1 + 0.48 × 0.74) × $33.4009 = $338.19

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.551
Practice expense1.951
Malpractice0.480.74

(2.55 × 1 + 1.95 × 1 + 0.48 × 0.74) × $33.4009 = $162.17

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

46230 · Office / nonfacility

$338.19

Effective 2026-10-01

The base rate is $39.56 higher than on 2025-10-01, moving from $298.63 to $338.19 (13.2%).

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

    $298.63changed to$338.19

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.62 changed to 2.55
    • Practice expense RVU 6.25 changed to 7.22
    • Malpractice RVU 0.49 changed to 0.48
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $298.63

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$338.19$162.17RVU26D
2026-07-01$338.19$162.17RVU26C
2026-04-01$338.19$162.17RVU26B
2026-01-01$338.19$162.17RVU26A
2025-10-01$298.63$166.98RVU25D
2025-07-01$298.63$166.98RVU25C
2025-04-01$298.63$166.98RVU25B
2025-01-01$298.63$166.98RVU25A

46230 billing questions

When should 46230 be selected instead of 46220?

Use 46230 when multiple anal tags are excised. Code 46220 represents excision of a single anal papilla or tag.

Can anal tag excision be reported as hemorrhoid removal?

No. 46230 describes removal of multiple skin tags; hemorrhoidectomy codes apply when hemorrhoidal tissue is excised. The operative note should make clear which tissue was treated.

Are related postoperative visits separately payable during the global period?

Related postoperative visits for 10 days are included in the global period for 46230.

Should modifier 50 be appended for tags on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

How are other procedures performed in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be billed for 46230?

Medicare does not pay an assistant at surgery for this code. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 46230PPRRVU2026_Oct_nonQPP.csv, line 5,582 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet