CPT code 46611: Anoscopy, snare lesion removal2026 Medicare rate & RVUs in Guam
Anoscopy with snare excision removes a tumor, polyp, or other lesion from the anal canal when the clinician uses snare technique.
Medicare pays $265.03 for 46611 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
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 9 sections
What 46611 covers
The clinician examines the anal canal with an anoscope and removes a tumor, polyp, or other lesion using a snare. Colorectal surgeons and gastroenterologists commonly perform this focused anorectal procedure in an office procedure room or facility setting. It is distinct from diagnostic-only anoscopy and from removal by other techniques.
Document the lesion treated and the snare technique used. Do not separately report diagnostic anoscopy as though it were a separate service when it is part of the removal. CMS assigns 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 for this anatomy and service. Medicare does not pay an assistant at surgery for this code; 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.
46611 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $265.03 | $75.53 |
How the 46611 rate is calculated
Each of 46611’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 · 46611
RVUs × geographic indexes × conversion factor
Work1.27
1.27 RVUs× 1.000 GPCI
Practice expense5.76
5.76 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
7.2300
Conversion factor
$33.4009
Medicare rate
$241.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46611
The CMS indicators that decide how 46611 is paid alongside other services.
CMS payment indicators · 46611
Anoscopy, snare lesion removal
| 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
46611 without 51 · national office
$241.49
Anoscopy, snare lesion removal
46611-51 · Second procedure: 50%
$120.75
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%).
46611 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46600Diagnostic anoscopyStandard visualization, optional washing
- 46600 is for diagnostic anoscopy, with or without specimen collection by brushing or washing. Select 46611 when the clinician removes a lesion using a snare.
- 46610AnoscopyHot forceps or bipolar cautery
- 46610 describes anoscopic removal of a foreign body. Code 46611 is for snare removal of a tumor, polyp, or other lesion.
- 46612AnoscopyLesion removal by excision
- Both codes involve anoscopic lesion removal, but 46611 specifies snare technique; 46612 specifies hot biopsy forceps or bipolar cautery.
- 46615AnoscopyLesion ablation
- 46615 is for lesion ablation. Use 46611 when the documented treatment is snare removal rather than ablation.
46611 billing questions
When should this code be selected instead of diagnostic anoscopy?
Use this code when the clinician removes a tumor, polyp, or other lesion with a snare. Diagnostic-only examination without snare removal is reported with 46600.
Can diagnostic anoscopy be billed separately on the same encounter?
The examination performed to locate and treat the lesion is part of the snare-removal service, rather than a separate diagnostic anoscopy.
How does this differ from anoscopic lesion removal with cautery?
This code identifies snare technique. Code 46612 is for lesion removal using hot biopsy forceps or bipolar cautery.
Should modifier 50 be used for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not describe this anorectal service.
What staffing and same-day care rules affect payment?
The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
What happens when related endoscopies are performed during the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The record should identify the services performed and the lesion-removal technique.
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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