Billing code 46916: Anal lesion treatmentMedicare rate & RVUs in Oregon
Reports simple destruction of anal lesion(s) by freezing, commonly for anal condylomata, when cryosurgery is the documented treatment method.
Medicare pays $251.46–$274.04 for 46916 in the office in Oregon, from Rest Of Oregon to Portland. 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 46916 covers
Code 46916 represents destruction of one or more anal lesions by freezing, most commonly anal condylomata. A colorectal or general surgeon typically applies a cryogenic agent to the lesion or lesions in an office procedure room or a facility setting. The code is distinguished by the cryosurgical method and simple treatment level, rather than extensive destruction.
Report it when the clinician documents cryosurgery and an extent consistent with simple treatment. The record should identify the treated lesion(s), anal site, method, and extent. The 10-day global period includes related postoperative visits during that period. When multiple procedures subject to the standard reduction are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is barred by statutory restriction, and co-surgeon and team-surgery billing 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 46916 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $274.04 | $127.46 |
| Rest Of Oregon | $251.46 | $120.05 |
How the 46916 rate is calculated
Each of 46916’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 · 46916
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.86Practice expense 5.55Malpractice 0.20
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46916
46916 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 46916
Anal lesion treatment
| 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 · 46916
Anal lesion treatment
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
46916 without 51 · national office
$254.18
Anal lesion treatment
46916-51 · Second procedure: 50%
$127.09
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%).
46916 compared with similar codes
Compare codes
46916 vs 46900 vs 46910 vs 46924 vs 46922: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46900Anal lesion destruction
- Choose 46900 for simple chemical destruction of anal lesions; 46916 is for simple destruction by freezing.
- 46910Anal lesion destruction
- Choose 46910 for simple electrosurgical destruction. Use 46916 when cryosurgery is the documented method.
- 46924Anal lesion destruction
- 46924 represents extensive anal lesion destruction; 46916 represents simple cryosurgical treatment.
- 46922Anal lesion excision
- 46922 is for excision, which removes lesion tissue. Code 46916 describes destruction by freezing.
46916 billing questions
How does 46916 differ from 46900 or 46910?
46916 identifies cryosurgery. The neighboring codes distinguish other simple destruction methods, including chemical treatment and electrosurgical treatment.
When should extensive destruction be considered instead?
Use 46924 when the documented destruction is extensive. Code 46916 is for simple treatment by cryosurgery.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How does Medicare apply the multiple-procedure reduction?
For qualifying procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted, and 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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