$276.90
Both address anal fissure treatment with sphincter dilation. Choose 46940 when fissurectomy is not performed; 46942 applies when fissurectomy is included.
On this page
CMS RVU26D · Effective 2026-10-01
46940 Anal fissure treatment Medicare reimbursement rates in Minnesota
Reports procedural treatment of an anal fissure with anal sphincter dilation when the fissure is managed without fissurectomy. Compare 46940 office and facility rates across CMS payment localities in Minnesota.
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.
What does Medicare pay for 46940 in Minnesota?
Minnesota has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$287.88
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$129.78
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Anorectal surgery
About 46940: Anal fissure treatment with dilation
Reports procedural treatment of an anal fissure with anal sphincter dilation when the fissure is managed without fissurectomy.
This code describes procedural management of an anal fissure that includes dilation of the anal sphincter, such as manual or balloon dilation, without fissurectomy. A surgeon, commonly a colorectal or general surgeon, may perform the treatment for a symptomatic fissure in an outpatient or facility setting. The record should identify the fissure and describe the treatment performed, including the dilation method and whether fissure tissue was excised.
Report 46940 when the documented service meets this treatment approach; use the related fissure code when fissurectomy is performed. 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 other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 46940
- 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 RVU2.29 · 26%
- Practice expense (office) RVU6.05 · 70%
- Malpractice RVU0.35 · 4%
378
Medicare services in 2024 · #3783 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.
46940 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$310.41
46080 describes incision of the anal sphincter. Use 46940 for fissure treatment involving dilation rather than sphincter incision.
$528.05
46200 is the fissurectomy approach. 46940 is distinguished by sphincter dilation without fissurectomy.
$248.11
46930 treats internal hemorrhoids, not an anal fissure. Select by the condition treated and the documented procedure.
Compare 46940 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Minnesota →
Office / nonfacility
$287.88
Facility
$129.78
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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 46940 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
5,637
- Code
- 46940
- Physician work
- 2.29
- Practice expense
- 6.05
- Malpractice
- 0.35
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.29 | × 1.000 | 2.2900 |
| Practice expense | 6.05 | × 1.029 | 6.2254 |
| Malpractice | 0.35 | × 0.296 | 0.1036 |
| Total RVUs | 8.6190 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$287.88
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.29 | 1 |
| Practice expense | 6.05 | 1.029 |
| Malpractice | 0.35 | 0.296 |
(2.29 × 1 + 6.05 × 1.029 + 0.35 × 0.296) × $33.4009 = $287.88
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.29 | 1 |
| Practice expense | 1.45 | 1.029 |
| Malpractice | 0.35 | 0.296 |
(2.29 × 1 + 1.45 × 1.029 + 0.35 × 0.296) × $33.4009 = $129.78
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.
46940 billing questions
How does 46940 differ from 46942?
46940 is for fissure treatment with sphincter dilation without fissurectomy. Use 46942 when the treatment includes fissurectomy.
What documentation supports 46940?
Document the anal fissure, the treatment performed, and the sphincter dilation method. Note whether fissure tissue was excised.
Are postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in 46940.
Can modifier 50 be used?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 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 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.
5,63446922,,Excision of anal lesion(s),A,,1.86,8.09,,1.80,,0.36,10.31,4.02,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63546924,,Destruction anal lesion(s),A,,2.74,15.44,,1.98,,0.43,18.61,5.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63646930,,Destroy internal hemorrhoids,A,,1.57,5.63,,2.93,,0.22,7.42,4.72,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63746940,,Treatment of anal fissure,A,,2.29,6.05,,1.45,,0.35,8.69,4.09,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63846942,,Treatment of anal fissure,A,,2.02,6.01,,1.39,,0.29,8.32,3.70,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,63946945,,Int hrhc lig 1 hroid w/o img,A,,3.60,6.27,NA,6.27,,0.62,10.49,10.49,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,64046946,,Int hrhc lig 2+hroid w/o img,A,,4.39,6.43,NA,6.43,,0.67,11.49,11.49,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002