Billing code 46922: Anal lesion excisionMedicare rate & RVUs in Guam
Surgical removal of one or more anal lesions, reported when the clinician excises tissue rather than destroying the lesion with an ablative method.
Medicare pays $376.32 for 46922 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
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.
46922 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $376.32 | $137.45 |
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
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.
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
| 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 · 46922
Anal lesion excision
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
46922 without 51 · national office
$344.36
Anal lesion excision
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%).
46922 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46900Anal lesion destruction
- Choose 46922 when the lesion is surgically excised. Code 46900 describes simple destruction, not removal by excision.
- 46910Anal lesion destruction
- Choose 46922 for excision. Code 46910 is for extensive destruction of anal lesions.
- 46916Anal lesion treatment
- Code 46916 identifies cryosurgery for anal lesions; 46922 applies when the clinician excises the lesion.
- 46917Anal lesion laser
- Code 46917 is for laser treatment of anal lesions. Report 46922 when the treatment is surgical excision instead.
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
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