CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 46942 RVU and Medicare Payment (2026)
Treatment of anal fissure — 2.02 work RVU, about $277.9 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.02
- PE RVU (non-facility)
- 6.01
- PE RVU (facility)
- 1.39
- MP RVU
- 0.29
- Office payment
- $277.9
- Facility payment
- $123.58
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 46942 in a non-facility setting with national GPCI: (2.02 + 6.01 + 0.29) × $33.4009 ≈ $277.9. The same code in a facility setting pays about $123.58 because facility PE RVU (1.39) replaces office PE RVU.
What changes by locality
GPCI moves 46942 non-facility payment from $244.89 to $369.55 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 46942?
2.02. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 46942 in 2026?
About $277.9 non-facility ($123.58 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (2.02) and malpractice RVU stay fixed; only practice expense changes (6.01 office vs 1.39 facility). That is the entire office-vs-facility payment gap.