CPT code 46601: Anoscopy, high-resolution, without biopsy2026 Medicare rate & RVUs in King County, WA
Reports high-resolution examination of the anal canal, with brushing or washing specimens when performed, for evaluating suspected anal dysplasia or other abnormalities.
In King County, WA, Medicare pays $191.59 for 46601 in the office and $92.82 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How King County, WA 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. King County, WA pays $191.59. The RVUs are the same everywhere; the geographic indexes change the dollars.
- King County, WA · this page$191.59
- Rest of Washington · Washington$170.67−$20.92
- Los Angeles, CA · California$185.34−$6.25
- Washington, DC area · District of Columbia$188.63−$2.96
- Miami, FL · Florida$181.11−$10.48
- Chicago, IL · Illinois$175.98−$15.61
- Manhattan, NY · New York$190.76−$0.83
Other areas in Washington first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $195.85 | $110.12 |
| 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 |
| Madera, CACalifornia | $173.89 | $85.67 |
| Merced, CACalifornia | $173.89 | $85.67 |
| Modesto, CACalifornia | $173.89 | $85.67 |
| Napa, CACalifornia | $199.82 | $93.73 |
| Oxnard, CACalifornia | $184.27 | $89.12 |
| Redding, CACalifornia | $173.89 | $85.67 |
| Rest of CaliforniaCalifornia | $173.89 | $85.67 |
| Riverside, CACalifornia | $176.17 | $87.95 |
| Sacramento, CACalifornia | $182.05 | $88.43 |
| Salinas, CACalifornia | $181.36 | $88.06 |
| San Diego, CACalifornia | $185.30 | $89.03 |
| Marin County, CACalifornia | $210.98 | $97.48 |
| San Francisco, CACalifornia | $210.74 | $97.24 |
| San Benito County, CACalifornia | $215.72 | $99.65 |
| Santa Clara County, CACalifornia | $214.75 | $98.67 |
| San Luis Obispo, CACalifornia | $178.49 | $86.81 |
| Santa Cruz, CACalifornia | $186.82 | $89.02 |
| Santa Maria, CACalifornia | $181.95 | $88.09 |
| Santa Rosa, CACalifornia | $188.68 | $89.83 |
| Stockton, CACalifornia | $173.89 | $85.67 |
| Vallejo, CACalifornia | $199.48 | $93.39 |
| Visalia, CACalifornia | $173.89 | $85.67 |
| Yuba City, CACalifornia | $173.89 | $85.67 |
| ColoradoColorado | $171.93 | $86.28 |
| ConnecticutConnecticut | $176.75 | $90.05 |
| DelawareDelaware | $164.27 | $84.74 |
| Fort Lauderdale, FLFlorida | $173.06 | $91.52 |
| Rest of FloridaFlorida | $164.83 | $87.87 |
| Atlanta, GAGeorgia | $169.28 | $87.49 |
| Rest of GeorgiaGeorgia | $155.81 | $84.00 |
| Hawaii, Guam, HIHawaii | $177.69 | $86.17 |
| IowaIowa | $152.69 | $79.03 |
| IdahoIdaho | $153.76 | $79.70 |
| East St. Louis, ILIllinois | $164.56 | $90.51 |
| Rest of IllinoisIllinois | $160.65 | $87.16 |
| Suburban Chicago, ILIllinois | $174.67 | $92.00 |
| IndianaIndiana | $154.59 | $79.97 |
| KansasKansas | $152.26 | $79.49 |
| KentuckyKentucky | $153.54 | $81.98 |
| New Orleans, LALouisiana | $160.65 | $84.90 |
| Rest of LouisianaLouisiana | $153.42 | $82.18 |
| Metropolitan Boston, MAMassachusetts | $188.10 | $91.99 |
| Rest of MassachusettsMassachusetts | $171.08 | $86.31 |
| Baltimore area, MDMaryland | $176.30 | $89.93 |
| Rest of MarylandMaryland | $167.23 | $85.77 |
| Rest of MaineMaine | $154.80 | $80.74 |
| Southern Maine, MEMaine | $162.45 | $82.68 |
| Detroit, MIMichigan | $167.07 | $89.39 |
| Rest of MichiganMichigan | $157.61 | $84.12 |
| MinnesotaMinnesota | $164.16 | $81.33 |
| Metropolitan Kansas City, MOMissouri | $159.32 | $83.74 |
| Metropolitan St. Louis, MOMissouri | $160.89 | $84.25 |
| Rest of MissouriMissouri | $151.07 | $81.68 |
| MississippiMississippi | $149.32 | $80.01 |
| MontanaMontana | $165.99 | $85.49 |
| North CarolinaNorth Carolina | $156.31 | $81.21 |
| North DakotaNorth Dakota | $161.84 | $81.34 |
| NebraskaNebraska | $153.41 | $79.11 |
| New HampshireNew Hampshire | $169.51 | $85.71 |
| Northern New JerseyNew Jersey | $186.86 | $93.49 |
| Rest of New JerseyNew Jersey | $178.60 | $90.70 |
| New MexicoNew Mexico | $158.54 | $84.73 |
| NevadaNevada | $164.94 | $84.36 |
| NYC suburbs and Long Island, NYNew York | $195.55 | $99.84 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $179.97 | $91.83 |
| Queens, NYNew York | $191.89 | $96.74 |
| Rest of New YorkNew York | $158.58 | $82.10 |
| OhioOhio | $156.76 | $83.27 |
| OklahomaOklahoma | $153.00 | $81.12 |
| Portland, OROregon | $176.90 | $87.47 |
| Rest of OregonOregon | $163.49 | $83.32 |
| Metropolitan Philadelphia, PAPennsylvania | $172.68 | $88.88 |
| Rest of PennsylvaniaPennsylvania | $156.85 | $82.96 |
| Puerto RicoPuerto Rico | $167.07 | $85.69 |
| Rhode IslandRhode Island | $169.76 | $86.61 |
| South CarolinaSouth Carolina | $156.83 | $82.45 |
| South DakotaSouth Dakota | $161.35 | $80.85 |
| TennesseeTennessee | $153.03 | $79.86 |
| Austin, TXTexas | $171.51 | $86.34 |
| Beaumont, TXTexas | $155.89 | $82.63 |
| Brazoria, TXTexas | $163.91 | $84.14 |
| Dallas, TXTexas | $165.05 | $84.87 |
| Fort Worth, TXTexas | $164.07 | $84.70 |
| Galveston, TXTexas | $164.46 | $84.53 |
| Houston, TXTexas | $168.31 | $88.38 |
| Rest of TexasTexas | $159.87 | $83.48 |
| UtahUtah | $158.87 | $83.21 |
| VirginiaVirginia | $162.12 | $83.00 |
| Virgin Islands, VIUnited States Virgin Islands | $167.07 | $85.69 |
| VermontVermont | $161.47 | $81.78 |
| WisconsinWisconsin | $156.66 | $79.54 |
| West VirginiaWest Virginia | $155.02 | $85.07 |
| WyomingWyoming | $164.18 | $83.68 |
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.
The exact King County, WA 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
108
- Locality
- King County, WA
- Physician work
- 1.050
- Practice expense
- 1.227
- Malpractice
- 0.817
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.56 | × 1.050 | 1.6380 |
| Practice expense | 3.20 | × 1.227 | 3.9264 |
| Malpractice | 0.21 | × 0.817 | 0.1716 |
| Total RVUs | 5.7360 | ||
| Conversion factor | × 33.4009 | ||
Office rate, King County, WA$191.59
Office: (1.56 × 1.05 + 3.2 × 1.227 + 0.21 × 0.817) × $33.4009 = $191.59
Facility: (1.56 × 1.05 + 0.79 × 1.227 + 0.21 × 0.817) × $33.4009 = $92.82
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%).
How 46601 has changed in King County, WA
46601 · Office / nonfacility
$191.59
Effective 2026-10-01
The base rate is $27.24 higher than on 2025-10-01, moving from $164.35 to $191.59 (16.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$164.35changed to$191.59
- 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
- Work GPCI 1.043 changed to 1.050
- Practice expense GPCI 1.220 changed to 1.227
- Malpractice GPCI 0.853 changed to 0.817
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$170.63changed to$164.35
- 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.
March 9, 2024
RVU24AR
$167.85changed to$170.63
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$171.21changed to$167.85
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.66 changed to 2.68
- Work GPCI 1.039 changed to 1.043
- Practice expense GPCI 1.207 changed to 1.220
- Malpractice GPCI 0.815 changed to 0.853
January 1, 2023
RVU23A
$176.34changed to$171.21
- 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
- Work GPCI 1.036 changed to 1.039
- Practice expense GPCI 1.194 changed to 1.207
- Malpractice GPCI 0.776 changed to 0.815
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$174.62changed to$176.34
- 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.
January 1, 2021
RVU21A
$162.93changed to$174.62
- 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
- Work GPCI 1.031 changed to 1.036
- Practice expense GPCI 1.170 changed to 1.194
- Malpractice GPCI 0.854 changed to 0.776
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$155.71changed to$162.93
- 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
- Work GPCI 1.027 changed to 1.031
- Practice expense GPCI 1.146 changed to 1.170
- Malpractice GPCI 0.931 changed to 0.854
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$151.98changed to$155.71
- 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.
January 1, 2018
RVU18AR1
$151.31changed to$151.98
- 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
- Work GPCI 1.026 changed to 1.027
- Practice expense GPCI 1.151 changed to 1.146
- Malpractice GPCI 0.713 changed to 0.931
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$151.00changed to$151.31
- 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
- Work GPCI 1.025 changed to 1.026
- Practice expense GPCI 1.155 changed to 1.151
- Malpractice GPCI 0.495 changed to 0.713
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$151.00
Held through RVU16B, RVU16C, RVU16D.
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $191.59 | $92.82 | RVU26D |
| 2026-07-01 | $191.59 | $92.82 | RVU26C |
| 2026-04-01 | $191.59 | $92.82 | RVU26B |
| 2026-01-01 | $191.59 | $92.82 | RVU26A |
| 2025-10-01 | $164.35 | $99.24 | RVU25D |
| 2025-07-01 | $164.35 | $99.24 | RVU25C |
| 2025-04-01 | $164.35 | $99.24 | RVU25B |
| 2025-01-01 | $164.35 | $99.24 | RVU25A |
| 2024-10-01 | $170.63 | $101.60 | RVU24D |
| 2024-07-01 | $170.63 | $101.60 | RVU24C |
| 2024-04-01 | $170.63 | $101.60 | RVU24B |
| 2024-03-09 | $170.63 | $101.60 | RVU24AR |
| 2024-01-01 | $167.85 | $99.94 | RVU24A |
| 2023-10-01 | $171.21 | $100.86 | RVU23D |
| 2023-07-01 | $171.21 | $100.86 | RVU23C |
| 2023-04-01 | $171.21 | $100.86 | RVU23B |
| 2023-01-01 | $171.21 | $100.86 | RVU23A |
| 2022-10-01 | $176.34 | $103.62 | RVU22D |
| 2022-07-01 | $176.34 | $103.62 | RVU22C |
| 2022-04-01 | $176.34 | $103.62 | RVU22B |
| 2022-01-01 | $176.34 | $103.62 | RVU22A |
| 2021-10-01 | $174.62 | $103.79 | RVU21D |
| 2021-07-01 | $174.62 | $103.79 | RVU21C |
| 2021-04-01 | $174.62 | $103.79 | RVU21B |
| 2021-01-01 | $174.62 | $103.79 | RVU21A |
| 2020-10-01 | $162.93 | $104.24 | RVU20D |
| 2020-07-01 | $162.93 | $104.24 | RVU20C |
| 2020-04-01 | $162.93 | $104.24 | RVU20B |
| 2020-01-01 | $162.93 | $104.24 | RVU20A |
| 2019-10-01 | $155.71 | $103.26 | RVU19D |
| 2019-07-01 | $155.71 | $103.26 | RVU19C |
| 2019-04-01 | $155.71 | $103.26 | RVU19B |
| 2019-01-01 | $155.71 | $103.26 | RVU19A |
| 2018-10-01 | $151.98 | $104.12 | RVU18D |
| 2018-07-01 | $151.98 | $104.12 | RVU18C |
| 2018-04-01 | $151.98 | $104.12 | RVU18B |
| 2018-01-01 | $151.98 | $104.12 | RVU18AR1 |
| 2017-10-01 | $151.31 | $102.98 | RVU17D |
| 2017-07-01 | $151.31 | $102.98 | RVU17C |
| 2017-04-01 | $151.31 | $102.98 | RVU17B |
| 2017-01-01 | $151.31 | $102.98 | RVU17A |
| 2016-10-01 | $151.00 | $101.37 | RVU16D |
| 2016-07-01 | $151.00 | $101.37 | RVU16C |
| 2016-04-01 | $151.00 | $101.37 | RVU16B |
| 2016-01-01 | $151.00 | $101.37 | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the King County, WA rate applies
King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.
- Seattle
- Algona
- Ames Lake
- 46601 in Auburn · multiple payment areas
- Baring
- Beaux Arts Village
- Bellevue
- Black Diamond
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
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