CPT code 46601: Anoscopy, high-resolution, without biopsy2026 Medicare rate & RVUs
Reports high-resolution examination of the anal canal, with brushing or washing specimens when performed, for evaluating suspected anal dysplasia or other abnormalities.
Medicare pays $166.00 for 46601 nationally in the office and $85.51 in a hospital or facility. Local office rates run $147.53–$215.72.
Medicare rate · 46601
Anoscopy, high-resolution, without biopsy
- Work RVUs
- 1.56
- Total RVUs
- 4.97
- Global days
- 000
National rate · 2026
$166.00
Office setting, before claim adjustments.
See every locality for 46601 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 10 sections
What 46601 covers
A clinician uses an anoscope with high-resolution magnification to inspect the anal canal and identify abnormalities such as lesions suspicious for anal dysplasia. Brushing or washing specimens may be collected during the examination. Colorectal surgeons and other clinicians trained in high-resolution anoscopy commonly perform it in office or facility settings, including evaluation after abnormal anal cytology or in patients with HPV-related risk.
Select this code when high-resolution magnification is used and no biopsy is performed; specimen collection by brushing or washing is included when done. The record should support the indication, the high-resolution examination, findings, and any specimens collected. This has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. Medicare does not pay for 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.
Where 46601 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$147.53 to $215.72
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $149.60 | $79.16 |
| Alaska | $195.85 | $110.12 |
| Arizona | $161.68 | $83.68 |
| Arkansas | $147.53 | $78.38 |
| Atlanta, GA | $169.28 | $87.49 |
| Austin, TX | $171.51 | $86.34 |
| Bakersfield, CA | $174.51 | $86.29 |
| Baltimore area, MD | $176.30 | $89.93 |
| Beaumont, TX | $155.89 | $82.63 |
| Brazoria, TX | $163.91 | $84.14 |
| Chicago, IL | $175.98 | $95.09 |
| Chico, CA | $173.89 | $85.67 |
| Colorado | $171.93 | $86.28 |
| Connecticut | $176.75 | $90.05 |
| Dallas, TX | $165.05 | $84.87 |
| Delaware | $164.27 | $84.74 |
| Detroit, MI | $167.07 | $89.39 |
| East St. Louis, IL | $164.56 | $90.51 |
| El Centro, CA | $173.93 | $85.71 |
| Fort Lauderdale, FL | $173.06 | $91.52 |
| Fort Worth, TX | $164.07 | $84.70 |
| Fresno, CA | $173.89 | $85.67 |
| Galveston, TX | $164.46 | $84.53 |
| Hanford, CA | $173.89 | $85.67 |
| Hawaii, Guam, HI | $177.69 | $86.17 |
| Houston, TX | $168.31 | $88.38 |
| Idaho | $153.76 | $79.70 |
| Indiana | $154.59 | $79.97 |
| Iowa | $152.69 | $79.03 |
| Kansas | $152.26 | $79.49 |
| Kentucky | $153.54 | $81.98 |
| King County, WA | $191.59 | $92.82 |
| Los Angeles, CA | $185.34 | $90.11 |
| Madera, CA | $173.89 | $85.67 |
| Manhattan, NY | $190.76 | $97.23 |
| Marin County, CA | $210.98 | $97.48 |
| Merced, CA | $173.89 | $85.67 |
| Metropolitan Boston, MA | $188.10 | $91.99 |
| Metropolitan Kansas City, MO | $159.32 | $83.74 |
| Metropolitan Philadelphia, PA | $172.68 | $88.88 |
| Metropolitan St. Louis, MO | $160.89 | $84.25 |
| Miami, FL | $181.11 | $97.31 |
| Minnesota | $164.16 | $81.33 |
| Mississippi | $149.32 | $80.01 |
| Modesto, CA | $173.89 | $85.67 |
| Montana | $165.99 | $85.49 |
| Napa, CA | $199.82 | $93.73 |
| Nebraska | $153.41 | $79.11 |
| Nevada | $164.94 | $84.36 |
| New Hampshire | $169.51 | $85.71 |
| New Mexico | $158.54 | $84.73 |
| New Orleans, LA | $160.65 | $84.90 |
| North Carolina | $156.31 | $81.21 |
| North Dakota | $161.84 | $81.34 |
| Northern New Jersey | $186.86 | $93.49 |
| NYC suburbs and Long Island, NY | $195.55 | $99.84 |
| Ohio | $156.76 | $83.27 |
| Oklahoma | $153.00 | $81.12 |
| Oxnard, CA | $184.27 | $89.12 |
| Portland, OR | $176.90 | $87.47 |
| Poughkeepsie and northern NYC suburbs, NY | $179.97 | $91.83 |
| Puerto Rico | $167.07 | $85.69 |
| Queens, NY | $191.89 | $96.74 |
| Redding, CA | $173.89 | $85.67 |
| Rest of California | $173.89 | $85.67 |
| Rest of Florida | $164.83 | $87.87 |
| Rest of Georgia | $155.81 | $84.00 |
| Rest of Illinois | $160.65 | $87.16 |
| Rest of Louisiana | $153.42 | $82.18 |
| Rest of Maine | $154.80 | $80.74 |
| Rest of Maryland | $167.23 | $85.77 |
| Rest of Massachusetts | $171.08 | $86.31 |
| Rest of Michigan | $157.61 | $84.12 |
| Rest of Missouri | $151.07 | $81.68 |
| Rest of New Jersey | $178.60 | $90.70 |
| Rest of New York | $158.58 | $82.10 |
| Rest of Oregon | $163.49 | $83.32 |
| Rest of Pennsylvania | $156.85 | $82.96 |
| Rest of Texas | $159.87 | $83.48 |
| Rest of Washington | $170.67 | $85.91 |
| Rhode Island | $169.76 | $86.61 |
| Riverside, CA | $176.17 | $87.95 |
| Sacramento, CA | $182.05 | $88.43 |
| Salinas, CA | $181.36 | $88.06 |
| San Benito County, CA | $215.72 | $99.65 |
| San Diego, CA | $185.30 | $89.03 |
| San Francisco, CA | $210.74 | $97.24 |
| San Luis Obispo, CA | $178.49 | $86.81 |
| Santa Clara County, CA | $214.75 | $98.67 |
| Santa Cruz, CA | $186.82 | $89.02 |
| Santa Maria, CA | $181.95 | $88.09 |
| Santa Rosa, CA | $188.68 | $89.83 |
| South Carolina | $156.83 | $82.45 |
| South Dakota | $161.35 | $80.85 |
| Southern Maine, ME | $162.45 | $82.68 |
| Stockton, CA | $173.89 | $85.67 |
| Suburban Chicago, IL | $174.67 | $92.00 |
| Tennessee | $153.03 | $79.86 |
| Utah | $158.87 | $83.21 |
| Vallejo, CA | $199.48 | $93.39 |
| Vermont | $161.47 | $81.78 |
| Virgin Islands, VI | $167.07 | $85.69 |
| Virginia | $162.12 | $83.00 |
| Visalia, CA | $173.89 | $85.67 |
| Washington, DC area | $188.63 | $93.81 |
| West Virginia | $155.02 | $85.07 |
| Wisconsin | $156.66 | $79.54 |
| Wyoming | $164.18 | $83.68 |
| Yuba City, CA | $173.89 | $85.67 |
46601 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$147.53
$195.85
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $195.85 | 1 |
| AL | $149.60 | 1 |
| AR | $147.53 | 1 |
| AZ | $161.68 | 1 |
| CA | $173.89–$215.72 | 29 |
| CO | $171.93 | 1 |
| CT | $176.75 | 1 |
| DC | $188.63 | 1 |
| DE | $164.27 | 1 |
| FL | $164.83–$181.11 | 3 |
| GA | $155.81–$169.28 | 2 |
| GU | $177.69 | 1 |
| HI | $177.69 | 1 |
| IA | $152.69 | 1 |
| ID | $153.76 | 1 |
| IL | $160.65–$175.98 | 4 |
| IN | $154.59 | 1 |
| KS | $152.26 | 1 |
| KY | $153.54 | 1 |
| LA | $153.42–$160.65 | 2 |
| MA | $171.08–$188.10 | 2 |
| MD | $167.23–$188.63 | 3 |
| ME | $154.80–$162.45 | 2 |
| MI | $157.61–$167.07 | 2 |
| MN | $164.16 | 1 |
| MO | $151.07–$160.89 | 3 |
| MS | $149.32 | 1 |
| MT | $165.99 | 1 |
| NC | $156.31 | 1 |
| ND | $161.84 | 1 |
| NE | $153.41 | 1 |
| NH | $169.51 | 1 |
| NJ | $178.60–$186.86 | 2 |
| NM | $158.54 | 1 |
| NV | $164.94 | 1 |
| NY | $158.58–$195.55 | 5 |
| OH | $156.76 | 1 |
| OK | $153.00 | 1 |
| OR | $163.49–$176.90 | 2 |
| PA | $156.85–$172.68 | 2 |
| PR | $167.07 | 1 |
| RI | $169.76 | 1 |
| SC | $156.83 | 1 |
| SD | $161.35 | 1 |
| TN | $153.03 | 1 |
| TX | $155.89–$171.51 | 8 |
| UT | $158.87 | 1 |
| VA | $162.12–$188.63 | 2 |
| VI | $167.07 | 1 |
| VT | $161.47 | 1 |
| WA | $170.67–$191.59 | 2 |
| WI | $156.66 | 1 |
| WV | $155.02 | 1 |
| WY | $164.18 | 1 |
How the 46601 rate is calculated
Each of 46601’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 · 46601
RVUs × geographic indexes × conversion factor
Work1.56
1.56 RVUs× 1.000 GPCI
Practice expense3.20
3.20 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
4.9700
Conversion factor
$33.4009
Medicare rate
$166.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46601
The CMS indicators that decide how 46601 is paid alongside other services.
CMS payment indicators · 46601
Anoscopy, high-resolution, without biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
46601 without 51 · national office
$166.00
Anoscopy, high-resolution, without biopsy
46601-51 · Second procedure: 50%
$83.00
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%).
46601 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 46600Diagnostic anoscopyStandard visualization, optional washing
- Choose 46601 when the examination uses high-resolution magnification. 46600 describes diagnostic anoscopy without that feature.
- 46606Anoscopy biopsyBiopsy performed
- 46606 is the biopsy option for anoscopy without high-resolution magnification. For high-resolution anoscopy with biopsy, consider 46607 instead.
- 46607AnoscopyHigh-resolution exam with biopsy
- Both involve high-resolution anoscopy; 46607 includes biopsy, while 46601 is used when no biopsy is performed.
46601 billing questions
How is this different from 46600?
46601 is for diagnostic anoscopy using high-resolution magnification. Use 46600 for diagnostic anoscopy without that high-resolution examination.
Can brushing or washing be reported separately?
No. Collection of specimens by brushing or washing is included when performed as part of this examination.
Can a biopsy be included with 46601?
No. When biopsy is performed during high-resolution anoscopy, 46607 is the more appropriate code to evaluate.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are related endoscopies priced when performed together?
Endoscopy family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code; 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
Fee sheets · Coming soon
Put 46601 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist