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CPT code 46612: Anoscopy, lesion removal by excision2026 Medicare rate & RVUs in Los Angeles, CA

Reports anoscopic excision of an anal canal lesion, such as a polyp or tumor, when the lesion is removed using an excisional technique.

CMS RVU26DEffective Oct 1, 2026One payment locality89 Medicare services in 2024

In Los Angeles, CA, Medicare pays $420.17 for 46612 in the office and $93.40 when it’s performed in a hospital or facility.

$420.17Office (non-facility)
$93.40Hospital or facility
+14.6%vs the national office rate ($366.74)

Check a contract rate as a % of Medicare · 46612 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 46612 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 46612 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 46612 covers

The clinician uses an anoscope to view the anal canal and surgically excise a tumor, polyp, or other lesion. Colorectal and general surgeons commonly perform this procedure in an office, outpatient department, or operating room. The removed tissue may be submitted for pathologic examination. This code distinguishes excision from lesion removal using hot biopsy forceps or bipolar cautery, snare removal, or ablation.

Select the code based on the technique documented, not merely the presence or number of lesions. The procedure note should identify the lesion site and extent, describe excision as the removal method, and record the specimens obtained. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code; co-surgery 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 Los Angeles, CA compares for 46612

Across 109 of 109 payment localities, the office rate for 46612 runs from $317.43 in Arkansas to $500.85 in San Benito County, CA. Los Angeles, CA pays $420.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

46612 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$420.17
  2. Bakersfield, CA · California$391.85−$28.32
  3. Chico, CA · California$390.80−$29.37
  4. El Centro, CA · California$390.87−$29.30
  5. Fresno, CA · California$390.80−$29.37
  6. Hanford, CA · California$390.80−$29.37
  7. Madera, CA · California$390.80−$29.37

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

Every other payment area

46612 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$390.80$88.06
Modesto, CACalifornia$390.80$88.06
Napa, CACalifornia$460.38$96.31
Oxnard, CACalifornia$418.70$92.20
Redding, CACalifornia$390.80$88.06
Rest of CaliforniaCalifornia$390.80$88.06
Riverside, CACalifornia$394.98$92.24
Sacramento, CACalifornia$412.16$90.91

46612 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.

$317.43

$445.83

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

View every state and territory as a table
46612 office rate range by state
State / territoryOffice rate rangeLocalities
AK$405.101
AL$322.971
AR$317.431
AZ$355.411
CA$390.80–$500.8529
CO$383.991
CT$393.931
DC$425.131
DE$362.011
FL$359.88–$399.163
GA$336.31–$374.392
GU$403.041
HI$403.041
IA$332.971
ID$335.481
IL$347.55–$385.484
IN$337.781
KS$331.011
KY$331.791
LA$331.13–$350.522
MA$381.04–$426.472
MD$369.82–$425.133
ME$337.42–$359.192
MI$341.89–$365.002
MN$366.411
MO$324.32–$352.133
MS$320.951
MT$366.721
NC$341.611
ND$359.001
NE$335.161
NH$377.621
NJ$398.01–$419.492
NM$344.051
NV$364.871
NY$347.63–$438.665
OH$340.321
OK$331.211
OR$361.65–$398.042
PA$341.02–$382.642
PR$369.901
RI$376.321
SC$341.611
SD$358.091
TN$332.961
TX$338.37–$383.048
UT$347.121
VA$357.73–$425.132
VI$369.901
VT$357.261
WA$380.42–$436.022
WI$344.921
WV$332.411
WY$363.361

See 46612 in every payment locality

How the 46612 rate is calculated

Each of 46612’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 · 46612

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.46

1.46 RVUs× 1.000 GPCI

Practice expense9.13

9.13 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

10.9800

Conversion factor

$33.4009

Medicare rate

$366.74

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

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,606

Code
46612
Physician work
1.46
Practice expense
9.13
Malpractice
0.39

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 46612 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0411.5199
Practice expense9.13× 1.18310.8008
Malpractice0.39× 0.6640.2590
Total RVUs12.5796
Conversion factor× 33.4009

Office rate, Los Angeles, CA$420.17

Office: (1.46 × 1.041 + 9.13 × 1.183 + 0.39 × 0.664) × $33.4009 = $420.17

Facility: (1.46 × 1.041 + 0.86 × 1.183 + 0.39 × 0.664) × $33.4009 = $93.40

Open 46612 in the RVU calculator

Payment rules and modifiers for 46612

The CMS indicators that decide how 46612 is paid alongside other services.

CMS payment indicators · 46612

Anoscopy, lesion removal by excision

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

46612 without 51 · national office

$366.74

Anoscopy, lesion removal by excision

46612-51 · Second procedure: 50%

$183.37

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 46612

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

Codes related to 46612
CodeHow it relatesOffice range, Los Angeles, CA
Same family
46610Anoscopy, hot forceps or bipolar cauteryAnoscopy with lesion removal using hot biopsy forceps or bipolar cautery.$352.03
46611Anoscopy, snare lesion removalAnoscopy with lesion removal by snare technique.$276.19
46615Anoscopy, lesion ablationAnoscopy with lesion ablation rather than excision.$216.24
46606Anoscopy biopsy, biopsy performedAnoscopy with biopsy, rather than excisional lesion removal.$354.11
46600Diagnostic anoscopy, standard visualization, optional washingDiagnostic anoscopy without the lesion-removal service.$148.57

How 46612 has changed in Los Angeles, CA

46612 · Office / nonfacility

$420.17

Effective 2026-10-01

The base rate is $60.43 higher than on 2025-10-01, moving from $359.74 to $420.17 (16.8%).

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

    $359.74changed to$420.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.50 changed to 1.46
    • Practice expense RVU 7.78 changed to 9.13
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $380.14changed to$359.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.03 changed to 7.78

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $373.94changed to$380.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $393.49changed to$373.94

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.25 changed to 8.03
    • Malpractice RVU 0.37 changed to 0.39
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $412.69changed to$393.49

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.56 changed to 8.25
    • Malpractice RVU 0.39 changed to 0.37
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $411.89changed to$412.69

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.47 changed to 8.56
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $364.72changed to$411.89

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.03 changed to 8.47
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $342.36changed to$364.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.52 changed to 7.03
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $342.11changed to$342.36

    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $322.25changed to$342.11

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.06 changed to 6.52

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $287.34changed to$322.25

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.30 changed to 6.06
    • Malpractice RVU 0.30 changed to 0.36
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $296.09changed to$287.34

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.52 changed to 5.30
    • Malpractice RVU 0.32 changed to 0.30
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $318.08changed to$296.09

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.99 changed to 5.52
    • Malpractice RVU 0.36 changed to 0.32

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $316.49changed to$318.08

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $310.73changed to$316.49

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.94 changed to 5.99
    • Malpractice RVU 0.30 changed to 0.36
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $325.45changed to$310.73

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.77 changed to 5.94
    • Malpractice RVU 0.31 changed to 0.30
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  17. October 1, 2013

    RVU13D

    No ratechanged to$325.45

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$420.17$93.40RVU26D
2026-07-01$420.17$93.40RVU26C
2026-04-01$420.17$93.40RVU26B
2026-01-01$420.17$93.40RVU26A
2025-10-01$359.74$97.88RVU25D
2025-07-01$359.74$97.88RVU25C
2025-04-01$359.74$97.88RVU25B
2025-01-01$359.74$97.88RVU25A
2024-10-01$380.14$99.54RVU24D
2024-07-01$380.14$99.54RVU24C
2024-04-01$380.14$99.54RVU24B
2024-03-09$380.14$99.54RVU24AR
2024-01-01$373.94$97.91RVU24A
2023-10-01$393.49$100.34RVU23D
2023-07-01$393.49$100.34RVU23C
2023-04-01$393.49$100.34RVU23B
2023-01-01$393.49$100.34RVU23A
2022-10-01$412.69$102.84RVU22D
2022-07-01$412.69$102.84RVU22C
2022-04-01$412.69$102.84RVU22B
2022-01-01$412.69$102.84RVU22A
2021-10-01$411.89$102.75RVU21D
2021-07-01$411.89$102.75RVU21C
2021-04-01$411.89$102.75RVU21B
2021-01-01$411.89$102.75RVU21A
2020-10-01$364.72$104.13RVU20D
2020-07-01$364.72$104.13RVU20C
2020-04-01$364.72$104.13RVU20B
2020-01-01$364.72$104.13RVU20A
2019-10-01$342.36$103.13RVU19D
2019-07-01$342.36$103.13RVU19C
2019-04-01$342.11$102.88RVU19B
2019-01-01$342.11$102.88RVU19A
2018-10-01$322.25$103.19RVU18D
2018-07-01$322.25$103.19RVU18C
2018-04-01$322.25$103.19RVU18B
2018-01-01$322.25$103.19RVU18AR1
2017-10-01$287.34$101.07RVU17D
2017-07-01$287.34$101.07RVU17C
2017-04-01$287.34$101.07RVU17B
2017-01-01$287.34$101.07RVU17A
2016-10-01$296.09$103.21RVU16D
2016-07-01$296.09$103.21RVU16C
2016-04-01$296.09$103.21RVU16B
2016-01-01$296.09$103.21RVU16A
2015-10-01$318.08$105.73RVU15D
2015-07-01$318.08$105.73RVU15C
2015-04-01$316.49$105.20RVU15B
2015-01-01$316.49$105.20RVU15A
2014-10-01$310.73$101.65RVU14D
2014-07-01$310.73$101.65RVU14C
2014-04-01$310.73$101.65RVU14B
2014-01-01$310.73$101.65RVU14A
2013-10-01$325.45$98.91RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46612 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

46612 billing questions

How is this code different from snare removal?

Use this code when the lesion is removed by excision. Anoscopy with snare removal is reported with 46611.

When would hot biopsy forceps or bipolar cautery apply instead?

Code 46610 describes lesion removal using hot biopsy forceps or bipolar cautery. Choose based on the documented removal technique.

Can diagnostic anoscopy be reported separately with the excision?

The diagnostic viewing is part of the anoscopic excision service. Endoscopy-family pricing applies when related endoscopies are performed together.

Is modifier 50 appropriate for lesions on both sides?

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

What does the 0-day global period mean?

Same-day preoperative and postoperative care is included. The global period for this procedure is 0 days.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgery 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 46612PPRRVU2026_Oct_nonQPP.csv, line 5,606 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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