CPT code 46601: Anoscopy, high-resolution, without biopsy2026 Medicare rate & RVUs in Kentucky

Reports high-resolution examination of the anal canal, with brushing or washing specimens when performed, for evaluating suspected anal dysplasia or other abnormalities.

CMS RVU26DEffective Oct 1, 2026One payment locality2.2K Medicare services in 2024

In Kentucky, Medicare pays $153.54 for 46601 in the office and $81.98 when it’s performed in a hospital or facility.

$153.54Office (non-facility)
$81.98Hospital or facility
−7.5%vs the national office rate ($166.00)

Check a contract rate as a % of Medicare · 46601 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 46601 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 46601 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Kentucky compares for 46601

Across 109 of 109 payment localities, the office rate for 46601 runs from $147.53 in Arkansas to $215.72 in San Benito County, CA. Kentucky pays $153.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

46601 in Kentucky vs other payment areas
  1. Kentucky · this page$153.54
  2. Los Angeles, CA · California$185.34+$31.80
  3. Washington, DC area · District of Columbia$188.63+$35.09
  4. Miami, FL · Florida$181.11+$27.57
  5. Chicago, IL · Illinois$175.98+$22.44
  6. Manhattan, NY · New York$190.76+$37.22
  7. Alaska · Alaska$195.85+$42.31

Other areas in Kentucky first, then benchmark localities. Bars start at $0.

Every other payment area

46601 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$149.60$79.16
ArkansasArkansas$147.53$78.38
ArizonaArizona$161.68$83.68
Bakersfield, CACalifornia$174.51$86.29
Chico, CACalifornia$173.89$85.67
El Centro, CACalifornia$173.93$85.71
Fresno, CACalifornia$173.89$85.67
Hanford, CACalifornia$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
46601 office rate range by state
State / territoryOffice rate rangeLocalities
AK$195.851
AL$149.601
AR$147.531
AZ$161.681
CA$173.89–$215.7229
CO$171.931
CT$176.751
DC$188.631
DE$164.271
FL$164.83–$181.113
GA$155.81–$169.282
GU$177.691
HI$177.691
IA$152.691
ID$153.761
IL$160.65–$175.984
IN$154.591
KS$152.261
KY$153.541
LA$153.42–$160.652
MA$171.08–$188.102
MD$167.23–$188.633
ME$154.80–$162.452
MI$157.61–$167.072
MN$164.161
MO$151.07–$160.893
MS$149.321
MT$165.991
NC$156.311
ND$161.841
NE$153.411
NH$169.511
NJ$178.60–$186.862
NM$158.541
NV$164.941
NY$158.58–$195.555
OH$156.761
OK$153.001
OR$163.49–$176.902
PA$156.85–$172.682
PR$167.071
RI$169.761
SC$156.831
SD$161.351
TN$153.031
TX$155.89–$171.518
UT$158.871
VA$162.12–$188.632
VI$167.071
VT$161.471
WA$170.67–$191.592
WI$156.661
WV$155.021
WY$164.181

See 46601 in every payment locality

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

Office or facility?

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.

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,599

Code
46601
Physician work
1.56
Practice expense
3.20
Malpractice
0.21

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 46601 in Kentucky
ComponentRVULocality factorAdjusted
Physician work1.56× 1.0001.5600
Practice expense3.20× 0.8892.8448
Malpractice0.21× 0.9150.1921
Total RVUs4.5969
Conversion factor× 33.4009

Office rate, Kentucky$153.54

Office: (1.56 × 1 + 3.2 × 0.889 + 0.21 × 0.915) × $33.4009 = $153.54

Facility: (1.56 × 1 + 0.79 × 0.889 + 0.21 × 0.915) × $33.4009 = $81.98

Open 46601 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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%).

When to use modifier 51

How 46601 has changed in Kentucky

46601 · Office / nonfacility

$153.54

Effective 2026-10-01

The base rate is $20.41 higher than on 2025-10-01, moving from $133.13 to $153.54 (15.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $133.13changed to$153.54

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.60 changed to 1.56
    • Practice expense RVU 2.65 changed to 3.20
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $138.18changed to$133.13

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.68 changed to 2.65
    • Malpractice RVU 0.22 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $135.93changed to$138.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $139.40changed to$135.93

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.66 changed to 2.68
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913
  5. January 1, 2023

    RVU23A

    $144.05changed to$139.40

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.73 changed to 2.66
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $142.83changed to$144.05

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.66 changed to 2.73
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $136.25changed to$142.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.31 changed to 2.66
    • Malpractice RVU 0.19 changed to 0.22
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $132.43changed to$136.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.19 changed to 2.31
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $129.48changed to$132.43

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.12 changed to 2.19
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $129.07changed to$129.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.15 changed to 2.12
    • Malpractice RVU 0.14 changed to 0.16
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $128.77changed to$129.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.18 changed to 2.15
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$128.77

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2015

    RVU15A

    No ratechanged toNo rate

    Held through RVU15B, RVU15C, RVU15D.

  14. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$153.54$81.98RVU26D
2026-07-01$153.54$81.98RVU26C
2026-04-01$153.54$81.98RVU26B
2026-01-01$153.54$81.98RVU26A
2025-10-01$133.13$86.32RVU25D
2025-07-01$133.13$86.32RVU25C
2025-04-01$133.13$86.32RVU25B
2025-01-01$133.13$86.32RVU25A
2024-10-01$138.18$88.56RVU24D
2024-07-01$138.18$88.56RVU24C
2024-04-01$138.18$88.56RVU24B
2024-03-09$138.18$88.56RVU24AR
2024-01-01$135.93$87.11RVU24A
2023-10-01$139.40$88.51RVU23D
2023-07-01$139.40$88.51RVU23C
2023-04-01$139.40$88.51RVU23B
2023-01-01$139.40$88.51RVU23A
2022-10-01$144.05$91.12RVU22D
2022-07-01$144.05$91.12RVU22C
2022-04-01$144.05$91.12RVU22B
2022-01-01$144.05$91.12RVU22A
2021-10-01$142.83$91.29RVU21D
2021-07-01$142.83$91.29RVU21C
2021-04-01$142.83$91.29RVU21B
2021-01-01$142.83$91.29RVU21A
2020-10-01$136.25$92.41RVU20D
2020-07-01$136.25$92.41RVU20C
2020-04-01$136.25$92.41RVU20B
2020-01-01$136.25$92.41RVU20A
2019-10-01$132.43$92.15RVU19D
2019-07-01$132.43$92.15RVU19C
2019-04-01$132.43$92.15RVU19B
2019-01-01$132.43$92.15RVU19A
2018-10-01$129.48$92.73RVU18D
2018-07-01$129.48$92.73RVU18C
2018-04-01$129.48$92.73RVU18B
2018-01-01$129.48$92.73RVU18AR1
2017-10-01$129.07$92.29RVU17D
2017-07-01$129.07$92.29RVU17C
2017-04-01$129.07$92.29RVU17B
2017-01-01$129.07$92.29RVU17A
2016-10-01$128.77$91.30RVU16D
2016-07-01$128.77$91.30RVU16C
2016-04-01$128.77$91.30RVU16B
2016-01-01$128.77$91.30RVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 46601 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

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
RVUs for 46601PPRRVU2026_Oct_nonQPP.csv, line 5,599 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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