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

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 Wisconsin, Medicare pays $289.86 for 46610 in the office and $69.72 when it’s performed in a hospital or facility.

$289.86Office (non-facility)
$69.72Hospital or facility
−5.3%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 Wisconsin
  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 Wisconsin 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. Wisconsin pays $289.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

46610 in Wisconsin vs other payment areas
  1. Wisconsin · this page$289.86
  2. Los Angeles, CA · California$352.03+$62.17
  3. Washington, DC area · District of Columbia$354.74+$64.88
  4. Miami, FL · Florida$328.22+$38.36
  5. Chicago, IL · Illinois$317.48+$27.62
  6. Manhattan, NY · New York$354.68+$64.82
  7. Alaska · Alaska$340.05+$50.19

Other areas in Wisconsin 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 Wisconsin 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

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office calculation for 46610 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0001.2500
Practice expense7.68× 0.9587.3574
Malpractice0.23× 0.3080.0708
Total RVUs8.6783
Conversion factor× 33.4009

Office rate, Wisconsin$289.86

Office: (1.25 × 1 + 7.68 × 0.958 + 0.23 × 0.308) × $33.4009 = $289.86

Facility: (1.25 × 1 + 0.8 × 0.958 + 0.23 × 0.308) × $33.4009 = $69.72

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, Wisconsin
Same family
46600Diagnostic anoscopy, standard visualization, optional washingDiagnostic anoscopy without the lesion removal reported here.$122.53
46606Anoscopy biopsy, biopsy performedAnoscopy with biopsy; sampling differs from removal by cautery.$291.36
Used instead
46611Anoscopy, snare lesion removalAnoscopic lesion removal by snare technique instead of cautery.$228.79
46612Anoscopy, lesion removal by excisionAnoscopic lesion removal by laser instead of cautery.$344.92
46615Anoscopy, lesion ablationAnoscopic lesion ablation rather than removal by hot forceps or bipolar cautery.$181.16

How 46610 has changed in Wisconsin

46610 · Office / nonfacility

$289.86

Effective 2026-10-01

The base rate is $43.54 higher than on 2025-10-01, moving from $246.32 to $289.86 (17.7%).

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

    $246.32changed to$289.86

    • 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
    • Practice expense GPCI 0.957 changed to 0.958
    • Malpractice GPCI 0.331 changed to 0.308

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $258.69changed to$246.32

    • 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

    $254.47changed to$258.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $266.88changed to$254.47

    • 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
    • Practice expense GPCI 0.950 changed to 0.957
    • Malpractice GPCI 0.314 changed to 0.331

  5. January 1, 2023

    RVU23A

    $276.35changed to$266.88

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.04 changed to 6.86
    • Practice expense GPCI 0.942 changed to 0.950
    • Malpractice GPCI 0.296 changed to 0.314

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $276.14changed to$276.35

    • 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

    $246.72changed to$276.14

    • 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
    • Practice expense GPCI 0.949 changed to 0.942
    • Malpractice GPCI 0.322 changed to 0.296

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $234.12changed to$246.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.36 changed to 5.77
    • Practice expense GPCI 0.957 changed to 0.949
    • Malpractice GPCI 0.347 changed to 0.322

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $223.31changed to$234.12

    • 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

    $220.03changed to$223.31

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.95 changed to 5.05
    • Practice expense GPCI 0.956 changed to 0.957
    • Malpractice GPCI 0.457 changed to 0.347

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $218.64changed to$220.03

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.90 changed to 4.95
    • Practice expense GPCI 0.955 changed to 0.956
    • Malpractice GPCI 0.566 changed to 0.457

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $219.98changed to$218.64

    • 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

    $218.89changed to$219.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $218.60changed to$218.89

    • 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 0.958 changed to 0.955
    • Malpractice GPCI 0.557 changed to 0.566

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $228.96changed to$218.60

    • 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 0.960 changed to 0.958
    • Malpractice GPCI 0.547 changed to 0.557

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$228.96

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$289.86$69.72RVU26D
2026-07-01$289.86$69.72RVU26C
2026-04-01$289.86$69.72RVU26B
2026-01-01$289.86$69.72RVU26A
2025-10-01$246.32$72.04RVU25D
2025-07-01$246.32$72.04RVU25C
2025-04-01$246.32$72.04RVU25B
2025-01-01$246.32$72.04RVU25A
2024-10-01$258.69$73.29RVU24D
2024-07-01$258.69$73.29RVU24C
2024-04-01$258.69$73.29RVU24B
2024-03-09$258.69$73.29RVU24AR
2024-01-01$254.47$72.09RVU24A
2023-10-01$266.88$73.72RVU23D
2023-07-01$266.88$73.72RVU23C
2023-04-01$266.88$73.72RVU23B
2023-01-01$266.88$73.72RVU23A
2022-10-01$276.35$74.24RVU22D
2022-07-01$276.35$74.24RVU22C
2022-04-01$276.35$74.24RVU22B
2022-01-01$276.35$74.24RVU22A
2021-10-01$276.14$74.32RVU21D
2021-07-01$276.14$74.32RVU21C
2021-04-01$276.14$74.32RVU21B
2021-01-01$276.14$74.32RVU21A
2020-10-01$246.72$76.84RVU20D
2020-07-01$246.72$76.84RVU20C
2020-04-01$246.72$76.84RVU20B
2020-01-01$246.72$76.84RVU20A
2019-10-01$234.12$76.50RVU19D
2019-07-01$234.12$76.50RVU19C
2019-04-01$234.12$76.50RVU19B
2019-01-01$234.12$76.50RVU19A
2018-10-01$223.31$77.23RVU18D
2018-07-01$223.31$77.23RVU18C
2018-04-01$223.31$77.23RVU18B
2018-01-01$223.31$77.23RVU18AR1
2017-10-01$220.03$78.34RVU17D
2017-07-01$220.03$78.34RVU17C
2017-04-01$220.03$78.34RVU17B
2017-01-01$220.03$78.34RVU17A
2016-10-01$218.64$78.45RVU16D
2016-07-01$218.64$78.45RVU16C
2016-04-01$218.64$78.45RVU16B
2016-01-01$218.64$78.45RVU16A
2015-10-01$219.98$79.28RVU15D
2015-07-01$219.98$79.28RVU15C
2015-04-01$218.89$78.89RVU15B
2015-01-01$218.89$78.89RVU15A
2014-10-01$218.60$78.24RVU14D
2014-07-01$218.60$78.24RVU14C
2014-04-01$218.60$78.24RVU14B
2014-01-01$218.60$78.24RVU14A
2013-10-01$228.96$77.74RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46610 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

  • Abbotsford
  • Abrams
  • Adams
  • Adell
  • Albany
  • Algoma
  • Allens Grove
  • Allenton

Browse all communities in Wisconsin

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 WisconsinGPCI2026.csv, line 111 (RVU26D)

Open CMS sourceHow we calculate rates

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