CPT code 46607: Anoscopy, high-resolution exam with biopsy2026 Medicare rate & RVUs
High-resolution anoscopy with biopsy examines the anal canal under magnification and collects tissue from suspicious areas, such as lesions evaluated for anal dysplasia.
Medicare pays $230.80 for 46607 nationally in the office and $113.23 in a hospital or facility. Local office rates run $204.94–$299.89.
Medicare rate · 46607
Anoscopy, high-resolution exam with biopsy
- Work RVUs
- 2.15
- Total RVUs
- 6.91
- Global days
- 000
National rate · 2026
$230.80
Office setting, before claim adjustments.
See every locality for 46607 →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.
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On this page 10 sections
What 46607 covers
This service uses high-resolution magnification to inspect the anal canal and obtain one or more tissue samples from areas that look abnormal. It is commonly performed by colorectal surgeons and other clinicians trained in high-resolution anoscopy to evaluate findings such as abnormal anal cytology or suspected anal dysplasia. The magnified examination helps identify areas for biopsy; routine anoscopy with biopsy does not include this high-resolution component.
Report the code when the documented service includes both high-resolution anoscopy and biopsy. The record should identify the reason for examination, use of magnification, relevant findings, biopsy sites, and whether tissue was collected. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. A bilateral modifier is inappropriate. Medicare does not pay an assistant at surgery for this service, 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 46607 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
$204.94 to $299.89
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $207.83 | $104.96 |
| Alaska | $271.89 | $146.68 |
| Arizona | $224.74 | $110.81 |
| Arkansas | $204.94 | $103.94 |
| Atlanta, GA | $235.41 | $115.96 |
| Austin, TX | $238.44 | $114.05 |
| Bakersfield, CA | $242.55 | $113.69 |
| Baltimore area, MD | $245.20 | $119.04 |
| Beaumont, TX | $216.68 | $109.69 |
| Brazoria, TX | $227.83 | $111.32 |
| Chicago, IL | $245.02 | $126.86 |
| Chico, CA | $241.67 | $112.81 |
| Colorado | $239.00 | $113.91 |
| Connecticut | $245.81 | $119.19 |
| Dallas, TX | $229.43 | $112.33 |
| Delaware | $228.36 | $112.20 |
| Detroit, MI | $232.46 | $119.00 |
| East St. Louis, IL | $229.04 | $120.88 |
| El Centro, CA | $241.72 | $112.86 |
| Fort Lauderdale, FL | $240.83 | $121.73 |
| Fort Worth, TX | $228.07 | $112.14 |
| Fresno, CA | $241.67 | $112.81 |
| Galveston, TX | $228.61 | $111.86 |
| Hanford, CA | $241.67 | $112.81 |
| Hawaii, Guam, HI | $246.99 | $113.31 |
| Houston, TX | $234.10 | $117.35 |
| Idaho | $213.60 | $105.44 |
| Indiana | $214.78 | $105.79 |
| Iowa | $212.10 | $104.52 |
| Kansas | $211.53 | $105.24 |
| Kentucky | $213.41 | $108.89 |
| King County, WA | $266.37 | $122.11 |
| Los Angeles, CA | $257.64 | $118.55 |
| Madera, CA | $241.67 | $112.81 |
| Manhattan, NY | $265.40 | $128.78 |
| Marin County, CA | $293.28 | $127.50 |
| Merced, CA | $241.67 | $112.81 |
| Metropolitan Boston, MA | $261.54 | $121.16 |
| Metropolitan Kansas City, MO | $221.48 | $111.08 |
| Metropolitan Philadelphia, PA | $240.13 | $117.74 |
| Metropolitan St. Louis, MO | $223.67 | $111.74 |
| Miami, FL | $252.23 | $129.84 |
| Minnesota | $228.07 | $107.09 |
| Mississippi | $207.48 | $106.25 |
| Modesto, CA | $241.67 | $112.81 |
| Montana | $230.78 | $113.21 |
| Napa, CA | $277.77 | $122.81 |
| Nebraska | $213.10 | $104.58 |
| Nevada | $229.28 | $111.59 |
| New Hampshire | $235.66 | $113.26 |
| New Mexico | $220.45 | $112.64 |
| New Orleans, LA | $223.37 | $112.74 |
| North Carolina | $217.20 | $107.51 |
| North Dakota | $224.85 | $107.28 |
| Northern New Jersey | $259.84 | $123.46 |
| NYC suburbs and Long Island, NY | $272.14 | $132.35 |
| Ohio | $217.92 | $110.58 |
| Oklahoma | $212.63 | $107.64 |
| Oxnard, CA | $256.15 | $117.18 |
| Portland, OR | $245.92 | $115.30 |
| Poughkeepsie and northern NYC suburbs, NY | $250.29 | $121.55 |
| Puerto Rico | $232.29 | $113.42 |
| Queens, NY | $266.94 | $127.97 |
| Redding, CA | $241.67 | $112.81 |
| Rest of California | $241.67 | $112.81 |
| Rest of Florida | $229.29 | $116.89 |
| Rest of Georgia | $216.64 | $111.76 |
| Rest of Illinois | $223.48 | $116.14 |
| Rest of Louisiana | $213.25 | $109.20 |
| Rest of Maine | $215.10 | $106.93 |
| Rest of Maryland | $232.48 | $113.50 |
| Rest of Massachusetts | $237.81 | $114.01 |
| Rest of Michigan | $219.13 | $111.79 |
| Rest of Missouri | $209.98 | $108.64 |
| Rest of New Jersey | $248.35 | $119.96 |
| Rest of New York | $220.38 | $108.68 |
| Rest of Oregon | $227.23 | $110.13 |
| Rest of Pennsylvania | $218.03 | $110.10 |
| Rest of Texas | $222.23 | $110.66 |
| Rest of Washington | $237.23 | $113.43 |
| Rhode Island | $236.00 | $114.55 |
| Riverside, CA | $244.92 | $116.06 |
| Sacramento, CA | $253.02 | $116.28 |
| Salinas, CA | $252.06 | $115.80 |
| San Benito County, CA | $299.89 | $130.36 |
| San Diego, CA | $257.56 | $116.95 |
| San Francisco, CA | $292.94 | $127.16 |
| San Luis Obispo, CA | $248.08 | $114.16 |
| Santa Clara County, CA | $298.50 | $128.96 |
| Santa Cruz, CA | $259.69 | $116.84 |
| Santa Maria, CA | $252.89 | $115.80 |
| Santa Rosa, CA | $262.27 | $117.89 |
| South Carolina | $217.98 | $109.34 |
| South Dakota | $224.15 | $106.58 |
| Southern Maine, ME | $225.76 | $109.25 |
| Stockton, CA | $241.67 | $112.81 |
| Suburban Chicago, IL | $243.06 | $122.32 |
| Tennessee | $212.60 | $105.73 |
| Utah | $220.84 | $110.32 |
| Vallejo, CA | $277.28 | $122.32 |
| Vermont | $224.36 | $107.97 |
| Virgin Islands, VI | $232.29 | $113.42 |
| Virginia | $225.32 | $109.75 |
| Visalia, CA | $241.67 | $112.81 |
| Washington, DC area | $262.33 | $123.83 |
| West Virginia | $215.60 | $113.43 |
| Wisconsin | $217.61 | $104.98 |
| Wyoming | $228.19 | $110.62 |
| Yuba City, CA | $241.67 | $112.81 |
46607 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.
$204.94
$271.89
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 | $271.89 | 1 |
| AL | $207.83 | 1 |
| AR | $204.94 | 1 |
| AZ | $224.74 | 1 |
| CA | $241.67–$299.89 | 29 |
| CO | $239.00 | 1 |
| CT | $245.81 | 1 |
| DC | $262.33 | 1 |
| DE | $228.36 | 1 |
| FL | $229.29–$252.23 | 3 |
| GA | $216.64–$235.41 | 2 |
| GU | $246.99 | 1 |
| HI | $246.99 | 1 |
| IA | $212.10 | 1 |
| ID | $213.60 | 1 |
| IL | $223.48–$245.02 | 4 |
| IN | $214.78 | 1 |
| KS | $211.53 | 1 |
| KY | $213.41 | 1 |
| LA | $213.25–$223.37 | 2 |
| MA | $237.81–$261.54 | 2 |
| MD | $232.48–$262.33 | 3 |
| ME | $215.10–$225.76 | 2 |
| MI | $219.13–$232.46 | 2 |
| MN | $228.07 | 1 |
| MO | $209.98–$223.67 | 3 |
| MS | $207.48 | 1 |
| MT | $230.78 | 1 |
| NC | $217.20 | 1 |
| ND | $224.85 | 1 |
| NE | $213.10 | 1 |
| NH | $235.66 | 1 |
| NJ | $248.35–$259.84 | 2 |
| NM | $220.45 | 1 |
| NV | $229.28 | 1 |
| NY | $220.38–$272.14 | 5 |
| OH | $217.92 | 1 |
| OK | $212.63 | 1 |
| OR | $227.23–$245.92 | 2 |
| PA | $218.03–$240.13 | 2 |
| PR | $232.29 | 1 |
| RI | $236.00 | 1 |
| SC | $217.98 | 1 |
| SD | $224.15 | 1 |
| TN | $212.60 | 1 |
| TX | $216.68–$238.44 | 8 |
| UT | $220.84 | 1 |
| VA | $225.32–$262.33 | 2 |
| VI | $232.29 | 1 |
| VT | $224.36 | 1 |
| WA | $237.23–$266.37 | 2 |
| WI | $217.61 | 1 |
| WV | $215.60 | 1 |
| WY | $228.19 | 1 |
How the 46607 rate is calculated
Each of 46607’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 · 46607
RVUs × geographic indexes × conversion factor
Work2.15
2.15 RVUs× 1.000 GPCI
Practice expense4.46
4.46 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
6.9100
Conversion factor
$33.4009
Medicare rate
$230.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46607
The CMS indicators that decide how 46607 is paid alongside other services.
CMS payment indicators · 46607
Anoscopy, high-resolution exam with 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
46607 without 51 · national office
$230.80
Anoscopy, high-resolution exam with biopsy
46607-51 · Second procedure: 50%
$115.40
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%).
46607 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 46606Anoscopy biopsyBiopsy performed
- Choose 46607 when the biopsy is performed during high-resolution magnified anoscopy. Choose 46606 for anoscopy with biopsy without that high-resolution component.
- 46601AnoscopyHigh-resolution, without biopsy
- 46601 describes high-resolution anoscopy without biopsy. When tissue is collected during the high-resolution examination, 46607 captures the combined service.
- 46600Diagnostic anoscopyStandard visualization, optional washing
- 46600 is diagnostic anoscopy without high-resolution magnification or biopsy. It does not represent the magnified examination and tissue collection included in 46607.
46607 billing questions
How does this differ from anoscopy with biopsy without high-resolution magnification?
This code includes high-resolution magnification as well as biopsy. Use the standard anoscopy biopsy code when biopsy is performed without that magnified examination.
Can the high-resolution examination be reported separately when a biopsy is taken?
The biopsy code includes the high-resolution examination. Do not separately report the high-resolution anoscopy-only service for the same examination.
Does the code include pathology analysis of the biopsy?
It covers the anoscopy and tissue collection, not the laboratory’s histologic examination of the specimen. Pathology may be reported by the provider or laboratory performing that separate service.
How many units are reported when multiple areas are biopsied?
The code covers single or multiple biopsies during the high-resolution anoscopy session; the number of tissue samples does not determine units.
Can modifier 50 or an assistant-at-surgery modifier be used?
No. CMS identifies bilateral adjustment as inappropriate for this code and does not pay an assistant at surgery for it.
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
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