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CPT code 46610: Anoscopy, hot forceps or bipolar cautery2026 Medicare rate & RVUs in Connecticut

Reports anoscopic removal of an anal canal lesion using hot biopsy forceps or bipolar cautery, rather than biopsy alone or another removal technique.

CMS RVU26DEffective Oct 1, 2026One payment locality138 Medicare services in 2024

In Connecticut, Medicare pays $328.15 for 46610 in the office and $80.66 when it’s performed in a hospital or facility.

$328.15Office (non-facility)
$80.66Hospital or facility
+7.3%vs the national office rate ($305.95)

Check a contract rate as a % of Medicare · 46610 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 46610 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 46610 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 46610 covers

A clinician examines the anal canal through an anoscope and removes a tumor, polyp, or other lesion using hot biopsy forceps or bipolar cautery. Colorectal surgeons and other clinicians who perform anorectal procedures may provide this service in an office or facility setting. The code is specific to removal with these cautery techniques; a lesion sampled for diagnosis without removal is a different service, as is removal by snare or laser.

Select this code when the procedure record supports both anoscopic access and removal using the specified technique. Document the lesion treated and how it was removed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Modifier 50 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.

How Connecticut compares for 46610

Across 109 of 109 payment localities, the office rate for 46610 runs from $266.06 in Arkansas to $420.36 in San Benito County, CA. Connecticut pays $328.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

46610 in Connecticut vs other payment areas
  1. Connecticut · this page$328.15
  2. Los Angeles, CA · California$352.03+$23.88
  3. Washington, DC area · District of Columbia$354.74+$26.59
  4. Miami, FL · Florida$328.22+$0.07
  5. Chicago, IL · Illinois$317.48−$10.67
  6. Manhattan, NY · New York$354.68+$26.53
  7. Alaska · Alaska$340.05+$11.90

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

Every other payment area

46610 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$270.55$69.48
ArkansasArkansas$266.06$68.66
ArizonaArizona$296.89$74.22
Bakersfield, CACalifornia$328.37$76.51
Chico, CACalifornia$327.72$75.86
El Centro, CACalifornia$327.76$75.90
Fresno, CACalifornia$327.72$75.86
Hanford, CACalifornia$327.72$75.86

46610 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$266.06

$374.04

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
46610 office rate range by state
State / territoryOffice rate rangeLocalities
AK$340.051
AL$270.551
AR$266.061
AZ$296.891
CA$327.72–$420.3629
CO$321.191
CT$328.151
DC$354.741
DE$302.311
FL$298.53–$328.223
GA$279.72–$311.732
GU$337.861
HI$337.861
IA$279.521
ID$281.381
IL$287.96–$319.104
IN$283.281
KS$277.521
KY$276.831
LA$276.13–$291.862
MA$318.66–$356.582
MD$308.82–$354.743
ME$282.53–$300.812
MI$284.63–$302.242
MN$307.981
MO$270.35–$293.653
MS$268.291
MT$305.941
NC$285.991
ND$301.391
NE$281.421
NH$315.511
NJ$331.97–$350.152
NM$286.211
NV$304.931
NY$290.84–$363.695
OH$283.701
OK$276.791
OR$302.64–$333.132
PA$284.50–$318.702
PR$308.661
RI$314.381
SC$285.301
SD$300.851
TN$279.051
TX$282.32–$320.048
UT$289.781
VA$299.33–$354.742
VI$308.661
VT$299.591
WA$318.25–$364.862
WI$289.861
WV$275.661
WY$303.951

See 46610 in every payment locality

How the 46610 rate is calculated

Each of 46610’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 · 46610

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense7.68

7.68 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

9.1600

Conversion factor

$33.4009

Medicare rate

$305.95

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,604

Code
46610
Physician work
1.25
Practice expense
7.68
Malpractice
0.23

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 46610 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0201.2750
Practice expense7.68× 1.0778.2714
Malpractice0.23× 1.2100.2783
Total RVUs9.8247
Conversion factor× 33.4009

Office rate, Connecticut$328.15

Office: (1.25 × 1.02 + 7.68 × 1.077 + 0.23 × 1.21) × $33.4009 = $328.15

Facility: (1.25 × 1.02 + 0.8 × 1.077 + 0.23 × 1.21) × $33.4009 = $80.66

Open 46610 in the RVU calculator

Payment rules and modifiers for 46610

The CMS indicators that decide how 46610 is paid alongside other services.

CMS payment indicators · 46610

Anoscopy, hot forceps or bipolar cautery

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

46610 without 51 · national office

$305.95

Anoscopy, hot forceps or bipolar cautery

46610-51 · Second procedure: 50%

$152.98

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

Codes related to 46610

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 46610
CodeHow it relatesOffice range, Connecticut
Same family
46600Diagnostic anoscopy, standard visualization, optional washingDiagnostic anoscopy without the lesion removal reported here.$138.18
46606Anoscopy biopsy, biopsy performedAnoscopy with biopsy; sampling differs from removal by cautery.$329.25
Used instead
46611Anoscopy, snare lesion removalAnoscopic lesion removal by snare technique instead of cautery.$258.55
46612Anoscopy, lesion removal by excisionAnoscopic lesion removal by laser instead of cautery.$393.93
46615Anoscopy, lesion ablationAnoscopic lesion ablation rather than removal by hot forceps or bipolar cautery.$204.64

How 46610 has changed in Connecticut

46610 · Office / nonfacility

$328.15

Effective 2026-10-01

The base rate is $46.06 higher than on 2025-10-01, moving from $282.09 to $328.15 (16.3%).

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

    $282.09changed to$328.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.28 changed to 1.25
    • Practice expense RVU 6.54 changed to 7.68
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $296.51changed to$282.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.70 changed to 6.54
    • Malpractice RVU 0.24 changed to 0.23

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $291.67changed to$296.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $309.92changed to$291.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.86 changed to 6.70
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $325.42changed to$309.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.04 changed to 6.86
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $324.74changed to$325.42

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.97 changed to 7.04
    • Malpractice RVU 0.23 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $289.17changed to$324.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.77 changed to 6.97
    • Malpractice RVU 0.25 changed to 0.23
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $273.21changed to$289.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.36 changed to 5.77
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $260.95changed to$273.21

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.05 changed to 5.36
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $257.04changed to$260.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.95 changed to 5.05
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $255.07changed to$257.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.90 changed to 4.95
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $256.83changed to$255.07

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.91 changed to 4.90
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $255.56changed to$256.83

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $253.01changed to$255.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.90 changed to 4.91
    • Malpractice RVU 0.23 changed to 0.27
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $263.90changed to$253.01

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.54 changed to 4.90
    • Malpractice RVU 0.24 changed to 0.23
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $263.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$328.15$80.66RVU26D
2026-07-01$328.15$80.66RVU26C
2026-04-01$328.15$80.66RVU26B
2026-01-01$328.15$80.66RVU26A
2025-10-01$282.09$83.41RVU25D
2025-07-01$282.09$83.41RVU25C
2025-04-01$282.09$83.41RVU25B
2025-01-01$282.09$83.41RVU25A
2024-10-01$296.51$85.15RVU24D
2024-07-01$296.51$85.15RVU24C
2024-04-01$296.51$85.15RVU24B
2024-03-09$296.51$85.15RVU24AR
2024-01-01$291.67$83.76RVU24A
2023-10-01$309.92$85.86RVU23D
2023-07-01$309.92$85.86RVU23C
2023-04-01$309.92$85.86RVU23B
2023-01-01$309.92$85.86RVU23A
2022-10-01$325.42$86.40RVU22D
2022-07-01$325.42$86.40RVU22C
2022-04-01$325.42$86.40RVU22B
2022-01-01$325.42$86.40RVU22A
2021-10-01$324.74$86.07RVU21D
2021-07-01$324.74$86.07RVU21C
2021-04-01$324.74$86.07RVU21B
2021-01-01$324.74$86.07RVU21A
2020-10-01$289.17$89.94RVU20D
2020-07-01$289.17$89.94RVU20C
2020-04-01$289.17$89.94RVU20B
2020-01-01$289.17$89.94RVU20A
2019-10-01$273.21$90.07RVU19D
2019-07-01$273.21$90.07RVU19C
2019-04-01$273.21$90.07RVU19B
2019-01-01$273.21$90.07RVU19A
2018-10-01$260.95$91.22RVU18D
2018-07-01$260.95$91.22RVU18C
2018-04-01$260.95$91.22RVU18B
2018-01-01$260.95$91.22RVU18AR1
2017-10-01$257.04$91.47RVU17D
2017-07-01$257.04$91.47RVU17C
2017-04-01$257.04$91.47RVU17B
2017-01-01$257.04$91.47RVU17A
2016-10-01$255.07$90.51RVU16D
2016-07-01$255.07$90.51RVU16C
2016-04-01$255.07$90.51RVU16B
2016-01-01$255.07$90.51RVU16A
2015-10-01$256.83$91.68RVU15D
2015-07-01$256.83$91.68RVU15C
2015-04-01$255.56$91.22RVU15B
2015-01-01$255.56$91.22RVU15A
2014-10-01$253.01$89.50RVU14D
2014-07-01$253.01$89.50RVU14C
2014-04-01$253.01$89.50RVU14B
2014-01-01$253.01$89.50RVU14A
2013-10-01$263.90$89.05RVU13D
2013-07-01$263.90$89.05RVU13C
2013-04-01$263.90$89.05RVU13B
2013-01-01$263.90$89.05RVU13AR

Price 46610 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

46610 billing questions

When should this code be chosen instead of an anoscopy with biopsy?

Use this code when the lesion is removed with hot biopsy forceps or bipolar cautery. An anoscopic biopsy code describes sampling tissue rather than the removal reported here.

How does this differ from anoscopic removal by snare or laser?

The method determines the code: this code is for hot biopsy forceps or bipolar cautery. Snare and laser removal are represented by separate technique-specific codes.

Is diagnostic anoscopy separately reported with lesion removal?

When related endoscopies are performed together, CMS applies endoscopy-family pricing. The diagnostic examination is part of the same procedural session, not an unrelated service.

Should modifier 50 be used for lesions on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

What should the procedure note establish?

Document the anal canal lesion treated and that removal was performed through an anoscope using hot biopsy forceps or bipolar cautery.

Can an assistant surgeon or co-surgeon be reported?

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 46610PPRRVU2026_Oct_nonQPP.csv, line 5,604 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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