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CPT code 46611: Anoscopy, snare lesion removal2026 Medicare rate & RVUs in Houston, TX

Anoscopy with snare excision removes a tumor, polyp, or other lesion from the anal canal when the clinician uses snare technique.

CMS RVU26DEffective Oct 1, 2026One payment locality187 Medicare services in 2024

In Houston, TX, Medicare pays $242.99 for 46611 in the office and $77.49 when it’s performed in a hospital or facility.

$242.99Office (non-facility)
$77.49Hospital or facility
+0.6%vs the national office rate ($241.49)

Check a contract rate as a % of Medicare · 46611 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 46611 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 46611 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 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.

How Houston, TX compares for 46611

Across 109 of 109 payment localities, the office rate for 46611 runs from $211.12 in Arkansas to $328.09 in San Benito County, CA. Houston, TX pays $242.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

46611 in Houston, TX vs other payment areas
  1. Houston, TX · this page$242.99
  2. Austin, TX · Texas$251.97+$8.98
  3. Beaumont, TX · Texas$223.70−$19.29
  4. Brazoria, TX · Texas$238.63−$4.36
  5. Dallas, TX · Texas$240.15−$2.84
  6. Fort Worth, TX · Texas$238.32−$4.67
  7. Galveston, TX · Texas$239.33−$3.66

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

Every other payment area

46611 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$231.03$72.86
Los Angeles, CACalifornia$276.19$79.02
Washington, DC areaDistrict of Columbia$278.78$82.44
Miami, FLFlorida$259.59$86.09
Chicago, ILIllinois$251.40$83.89
Manhattan, NYNew York$279.28$85.61
AlaskaAlaska$272.20$94.70
AlabamaAlabama$214.54$68.70

46611 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.

$211.12

$292.84

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

View every state and territory as a table
46611 office rate range by state
State / territoryOffice rate rangeLocalities
AK$272.201
AL$214.541
AR$211.121
AZ$234.561
CA$257.58–$328.0929
CO$252.851
CT$258.551
DC$278.781
DE$238.721
FL$236.38–$259.593
GA$221.99–$246.042
GU$265.031
HI$265.031
IA$221.111
ID$222.581
IL$228.51–$252.144
IN$224.011
KS$219.711
KY$219.571
LA$219.08–$231.052
MA$251.01–$279.822
MD$243.67–$278.783
ME$223.57–$237.292
MI$225.61–$239.342
MN$242.361
MO$214.77–$232.273
MS$213.001
MT$241.481
NC$226.191
ND$237.521
NE$222.521
NH$248.541
NJ$261.53–$275.402
NM$226.861
NV$240.571
NY$229.89–$286.295
OH$224.801
OK$219.411
OR$238.73–$261.812
PA$225.35–$251.432
PR$243.501
RI$247.921
SC$225.861
SD$237.051
TN$220.891
TX$223.70–$251.978
UT$229.261
VA$236.25–$278.782
VI$243.501
VT$236.261
WA$250.64–$286.062
WI$228.791
WV$219.161
WY$239.751

See 46611 in every payment locality

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

Office or facility?

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.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,605

Code
46611
Physician work
1.27
Practice expense
5.76
Malpractice
0.20

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 46611 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.27× 1.0081.2802
Practice expense5.76× 0.9935.7197
Malpractice0.20× 1.3760.2752
Total RVUs7.2750
Conversion factor× 33.4009

Office rate, Houston, TX$242.99

Office: (1.27 × 1.008 + 5.76 × 0.993 + 0.2 × 1.376) × $33.4009 = $242.99

Facility: (1.27 × 1.008 + 0.77 × 0.993 + 0.2 × 1.376) × $33.4009 = $77.49

Open 46611 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 46611

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

Codes related to 46611
CodeHow it relatesOffice range, Houston, TX
Used instead
46600Diagnostic anoscopy, standard visualization, optional washingDiagnostic-only anoscopy without snare removal is reported with this code.$129.32
46610Anoscopy, hot forceps or bipolar cauteryAnoscopic removal of a foreign body rather than a tumor, polyp, or lesion.$307.38
46612Anoscopy, lesion removal by excisionAnoscopic lesion removal using hot biopsy forceps or bipolar cautery.$369.90
46614Anoscopy, bleeding controlAnoscopy to control bleeding rather than to remove a lesion by snare.$184.63
46615Anoscopy, lesion ablationAnoscopic lesion ablation rather than snare removal.$193.80
46606Anoscopy biopsy, biopsy performedAnoscopic biopsy when tissue sampling, rather than snare excision, is performed.$307.95
Same family
46604Anoscopy, with dilationAnoscopy with dilation; a different therapeutic service in the anoscopy code family.$689.03

How 46611 has changed in Houston, TX

46611 · Office / nonfacility

$242.99

Effective 2026-10-01

The base rate is $27.91 higher than on 2025-10-01, moving from $215.08 to $242.99 (13.0%).

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

    $215.08changed to$242.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.30 changed to 1.27
    • Practice expense RVU 5.02 changed to 5.76
    • Malpractice RVU 0.21 changed to 0.20
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $226.54changed to$215.08

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.19 changed to 5.02
    • Malpractice RVU 0.20 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $222.84changed to$226.54

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $233.25changed to$222.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.25 changed to 5.19
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $246.37changed to$233.25

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.44 changed to 5.25
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $242.72changed to$246.37

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.29 changed to 5.44
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $212.35changed to$242.72

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.29 changed to 5.29
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $197.84changed to$212.35

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.92 changed to 4.29
    • Malpractice RVU 0.21 changed to 0.19
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $185.94changed to$197.84

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.59 changed to 3.92
    • Malpractice RVU 0.22 changed to 0.21

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $182.16changed to$185.94

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.51 changed to 3.59
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $180.66changed to$182.16

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.49 changed to 3.51
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $180.59changed to$180.66

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.47 changed to 3.49

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $179.69changed to$180.59

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $179.06changed to$179.69

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.46 changed to 3.47
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $182.76changed to$179.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.84 changed to 3.46
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $182.76

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$242.99$77.49RVU26D
2026-07-01$242.99$77.49RVU26C
2026-04-01$242.99$77.49RVU26B
2026-01-01$242.99$77.49RVU26A
2025-10-01$215.08$81.73RVU25D
2025-07-01$215.08$81.73RVU25C
2025-04-01$215.08$81.73RVU25B
2025-01-01$215.08$81.73RVU25A
2024-10-01$226.54$83.64RVU24D
2024-07-01$226.54$83.64RVU24C
2024-04-01$226.54$83.64RVU24B
2024-03-09$226.54$83.64RVU24AR
2024-01-01$222.84$82.28RVU24A
2023-10-01$233.25$83.14RVU23D
2023-07-01$233.25$83.14RVU23C
2023-04-01$233.25$83.14RVU23B
2023-01-01$233.25$83.14RVU23A
2022-10-01$246.37$83.64RVU22D
2022-07-01$246.37$83.64RVU22C
2022-04-01$246.37$83.64RVU22B
2022-01-01$246.37$83.64RVU22A
2021-10-01$242.72$83.30RVU21D
2021-07-01$242.72$83.30RVU21C
2021-04-01$242.72$83.30RVU21B
2021-01-01$242.72$83.30RVU21A
2020-10-01$212.35$84.62RVU20D
2020-07-01$212.35$84.62RVU20C
2020-04-01$212.35$84.62RVU20B
2020-01-01$212.35$84.62RVU20A
2019-10-01$197.84$84.78RVU19D
2019-07-01$197.84$84.78RVU19C
2019-04-01$197.84$84.78RVU19B
2019-01-01$197.84$84.78RVU19A
2018-10-01$185.94$85.75RVU18D
2018-07-01$185.94$85.75RVU18C
2018-04-01$185.94$85.75RVU18B
2018-01-01$185.94$85.75RVU18AR1
2017-10-01$182.16$85.48RVU17D
2017-07-01$182.16$85.48RVU17C
2017-04-01$182.16$85.48RVU17B
2017-01-01$182.16$85.48RVU17A
2016-10-01$180.66$84.85RVU16D
2016-07-01$180.66$84.85RVU16C
2016-04-01$180.66$84.85RVU16B
2016-01-01$180.66$84.85RVU16A
2015-10-01$180.59$85.52RVU15D
2015-07-01$180.59$85.52RVU15C
2015-04-01$179.69$85.09RVU15B
2015-01-01$179.69$85.09RVU15A
2014-10-01$179.06$84.83RVU14D
2014-07-01$179.06$84.83RVU14C
2014-04-01$179.06$84.83RVU14B
2014-01-01$179.06$84.83RVU14A
2013-10-01$182.76$83.21RVU13D
2013-07-01$182.76$83.21RVU13C
2013-04-01$182.76$83.21RVU13B
2013-01-01$182.76$83.21RVU13AR

Price 46611 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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

Show the CMS file lines behind this rate
RVUs for 46611PPRRVU2026_Oct_nonQPP.csv, line 5,605 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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