Summary & Overview
CPT 46220: Excision of External Anal Papilla (Skin Tag)
CPT code 46220 identifies the excision of an external anal papilla or skin tag, a minor anorectal surgical procedure frequently performed to relieve symptoms or to aid management of adjacent fissures or fistulas. Nationally, this code matters because it captures a common outpatient surgical intervention in colorectal and general surgery practices and informs payment, quality measurement, and utilization monitoring for anorectal care.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and the payer landscape covered in this analysis. The publication reviews national benchmarks for utilization and reimbursement patterns where available, highlights relevant policy considerations affecting outpatient minor surgical procedures, and situates 46220 within common clinical workflows for anal fissure and fistula management.
This summary equips clinicians, coding professionals, and policy analysts with concise guidance on what CPT code 46220 represents, why it is billed, and what to expect when evaluating claims and coverage decisions for minor anorectal excisions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 46220 describes the surgical removal of an external anal papilla or skin tag located at the external margin of the anus. The procedure addresses small, external benign lesions that are often associated with the edge of an anal fissure or fistula and may be excised for symptomatic relief or to facilitate treatment of the primary anorectal condition.
Service Type: Minor surgical excision of external anorectal skin lesion
Typical Site of Service: Ambulatory surgical center or outpatient clinic/procedural room, often performed under local anesthesia. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to an outpatient colorectal clinic with a several-week history of pain and occasional bleeding at the anal verge. On examination the clinician identifies an external anal papilla (skin tag) adjacent to the external edge of a chronic anal fissure. Conservative measures have been attempted but the lesion causes hygiene difficulty and persistent discomfort. The patient is scheduled for a minor office-based procedure under local anesthesia. The clinical workflow includes pre-procedure consent, focused anorectal exam and photography as indicated, local infiltration anesthesia (for example, 1% lidocaine), excision of the external papilla with scissors or electrocautery, hemostasis, specimen handling if indicated, wound dressing, and post-procedure instructions with follow-up for wound check and pathology results if the specimen is sent.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Unusual procedural service (separate identifiable E/M) | Use when a significant, separately identifiable E/M visit is reported on the same day as the procedure. |
22 | Increased procedural services | Use when the work required to remove the lesion is substantially greater than typical for the code. |