CPT code 46612: Anoscopy, lesion removal by excision2026 Medicare rate & RVUs in Illinois
Reports anoscopic excision of an anal canal lesion, such as a polyp or tumor, when the lesion is removed using an excisional technique.
Medicare pays $347.55–$385.48 for 46612 in the office in Illinois, from Rest of Illinois to Chicago, IL. 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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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.
Where 46612 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$347.55 to $385.48
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $385.48 | $107.87 |
| East St. Louis, IL | $355.55 | $101.43 |
| Rest of Illinois | $347.55 | $95.35 |
| Suburban Chicago, IL | $385.37 | $101.69 |
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
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.
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
| 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
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%).
46612 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46610AnoscopyHot forceps or bipolar cautery
- Use 46610 when lesion removal is performed with hot biopsy forceps or bipolar cautery. This code is for removal by excision.
- 46611AnoscopySnare lesion removal
- Use 46611 for lesion removal by snare technique; use 46612 when the documented technique is excision.
- 46615AnoscopyLesion ablation
- 46615 describes ablation of lesions, rather than their removal by excision.
- 46606Anoscopy biopsyBiopsy performed
- 46606 is for anoscopic biopsy. This code describes excision of a lesion, not sampling alone.
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
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