CPT code 46612: Anoscopy, lesion removal by excision2026 Medicare rate & RVUs in Wyoming
Reports anoscopic excision of an anal canal lesion, such as a polyp or tumor, when the lesion is removed using an excisional technique.
In Wyoming, Medicare pays $363.36 for 46612 in the office and $87.13 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Wyoming 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. Wyoming pays $363.36. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Wyoming · this page$363.36
- Los Angeles, CA · California$420.17+$56.81
- Washington, DC area · District of Columbia$425.13+$61.77
- Miami, FL · Florida$399.16+$35.80
- Chicago, IL · Illinois$385.48+$22.12
- Manhattan, NY · New York$426.90+$63.54
- Alaska · Alaska$405.10+$41.74
Other areas in Wyoming first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $322.97 | $81.27 |
| ArkansasArkansas | $317.43 | $80.15 |
| ArizonaArizona | $355.41 | $87.75 |
| Bakersfield, CACalifornia | $391.85 | $89.11 |
| Chico, CACalifornia | $390.80 | $88.06 |
| El Centro, CACalifornia | $390.87 | $88.12 |
| Fresno, CACalifornia | $390.80 | $88.06 |
| Hanford, CACalifornia | $390.80 | $88.06 |
| Madera, CACalifornia | $390.80 | $88.06 |
| 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 |
| Salinas, CACalifornia | $410.70 | $90.55 |
| San Diego, CACalifornia | $422.01 | $91.64 |
| Marin County, CACalifornia | $489.36 | $99.88 |
| San Francisco, CACalifornia | $488.91 | $99.44 |
| San Benito County, CACalifornia | $500.85 | $102.53 |
| Santa Clara County, CACalifornia | $499.04 | $100.72 |
| San Luis Obispo, CACalifornia | $403.91 | $89.29 |
| Santa Cruz, CACalifornia | $427.29 | $91.67 |
| Santa Maria, CACalifornia | $412.68 | $90.61 |
| Santa Rosa, CACalifornia | $431.69 | $92.48 |
| Stockton, CACalifornia | $390.80 | $88.06 |
| Vallejo, CACalifornia | $459.74 | $95.68 |
| Visalia, CACalifornia | $390.80 | $88.06 |
| Yuba City, CACalifornia | $390.80 | $88.06 |
| ColoradoColorado | $383.99 | $90.09 |
| ConnecticutConnecticut | $393.93 | $96.44 |
| DelawareDelaware | $362.01 | $89.10 |
| Fort Lauderdale, FLFlorida | $381.23 | $101.42 |
| Rest of FloridaFlorida | $359.88 | $95.80 |
| Atlanta, GAGeorgia | $374.39 | $93.74 |
| Rest of GeorgiaGeorgia | $336.31 | $89.92 |
| Hawaii, Guam, HIHawaii | $403.04 | $88.97 |
| IowaIowa | $332.97 | $80.22 |
| IdahoIdaho | $335.48 | $81.35 |
| East St. Louis, ILIllinois | $355.55 | $101.43 |
| Rest of IllinoisIllinois | $347.55 | $95.35 |
| Suburban Chicago, ILIllinois | $385.37 | $101.69 |
| IndianaIndiana | $337.78 | $81.72 |
| KansasKansas | $331.01 | $81.30 |
| KentuckyKentucky | $331.79 | $86.22 |
| New Orleans, LALouisiana | $350.52 | $90.59 |
| Rest of LouisianaLouisiana | $331.13 | $86.67 |
| Metropolitan Boston, MAMassachusetts | $426.47 | $96.66 |
| Rest of MassachusettsMassachusetts | $381.04 | $90.17 |
| Baltimore area, MDMaryland | $392.87 | $96.48 |
| Rest of MarylandMaryland | $369.82 | $90.28 |
| Rest of MaineMaine | $337.42 | $83.29 |
| Southern Maine, MEMaine | $359.19 | $85.45 |
| Detroit, MIMichigan | $365.00 | $98.45 |
| Rest of MichiganMichigan | $341.89 | $89.70 |
| MinnesotaMinnesota | $366.41 | $82.18 |
| Metropolitan Kansas City, MOMissouri | $347.84 | $88.46 |
| Metropolitan St. Louis, MOMissouri | $352.13 | $89.16 |
| Rest of MissouriMissouri | $324.32 | $86.21 |
| MississippiMississippi | $320.95 | $83.12 |
| MontanaMontana | $366.72 | $90.49 |
| North CarolinaNorth Carolina | $341.61 | $83.89 |
| North DakotaNorth Dakota | $359.00 | $82.78 |
| NebraskaNebraska | $335.16 | $80.20 |
| New HampshireNew Hampshire | $377.62 | $90.07 |
| Northern New JerseyNew Jersey | $419.49 | $99.07 |
| Rest of New JerseyNew Jersey | $398.01 | $96.37 |
| New MexicoNew Mexico | $344.05 | $90.75 |
| NevadaNevada | $364.87 | $88.37 |
| NYC suburbs and Long Island, NYNew York | $438.66 | $110.23 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $400.64 | $98.18 |
| Queens, NYNew York | $431.12 | $104.62 |
| Rest of New YorkNew York | $347.63 | $85.21 |
| OhioOhio | $340.32 | $88.12 |
| OklahomaOklahoma | $331.21 | $84.54 |
| Portland, OROregon | $398.04 | $91.15 |
| Rest of OregonOregon | $361.65 | $86.53 |
| Metropolitan Philadelphia, PAPennsylvania | $382.64 | $95.09 |
| Rest of PennsylvaniaPennsylvania | $341.02 | $87.44 |
| Puerto RicoPuerto Rico | $369.90 | $90.64 |
| Rhode IslandRhode Island | $376.32 | $90.98 |
| South CarolinaSouth Carolina | $341.61 | $86.38 |
| South DakotaSouth Dakota | $358.09 | $81.87 |
| TennesseeTennessee | $332.96 | $81.87 |
| Austin, TXTexas | $383.04 | $90.80 |
| Beaumont, TXTexas | $338.37 | $87.01 |
| Brazoria, TXTexas | $361.52 | $87.78 |
| Dallas, TXTexas | $364.11 | $88.99 |
| Fort Worth, TXTexas | $361.23 | $88.87 |
| Galveston, TXTexas | $362.76 | $88.46 |
| Houston, TXTexas | $369.90 | $95.60 |
| Rest of TexasTexas | $349.93 | $87.79 |
| UtahUtah | $347.12 | $87.46 |
| VirginiaVirginia | $357.73 | $86.20 |
| Virgin Islands, VIUnited States Virgin Islands | $369.90 | $90.64 |
| VermontVermont | $357.26 | $83.79 |
| Rest of WashingtonWashington | $380.42 | $89.56 |
| King County, WAWashington | $436.02 | $97.09 |
| WisconsinWisconsin | $344.92 | $80.30 |
| West VirginiaWest Virginia | $332.41 | $92.37 |
46612 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $405.10 | 1 |
| AL | $322.97 | 1 |
| AR | $317.43 | 1 |
| AZ | $355.41 | 1 |
| CA | $390.80–$500.85 | 29 |
| CO | $383.99 | 1 |
| CT | $393.93 | 1 |
| DC | $425.13 | 1 |
| DE | $362.01 | 1 |
| FL | $359.88–$399.16 | 3 |
| GA | $336.31–$374.39 | 2 |
| GU | $403.04 | 1 |
| HI | $403.04 | 1 |
| IA | $332.97 | 1 |
| ID | $335.48 | 1 |
| IL | $347.55–$385.48 | 4 |
| IN | $337.78 | 1 |
| KS | $331.01 | 1 |
| KY | $331.79 | 1 |
| LA | $331.13–$350.52 | 2 |
| MA | $381.04–$426.47 | 2 |
| MD | $369.82–$425.13 | 3 |
| ME | $337.42–$359.19 | 2 |
| MI | $341.89–$365.00 | 2 |
| MN | $366.41 | 1 |
| MO | $324.32–$352.13 | 3 |
| MS | $320.95 | 1 |
| MT | $366.72 | 1 |
| NC | $341.61 | 1 |
| ND | $359.00 | 1 |
| NE | $335.16 | 1 |
| NH | $377.62 | 1 |
| NJ | $398.01–$419.49 | 2 |
| NM | $344.05 | 1 |
| NV | $364.87 | 1 |
| NY | $347.63–$438.66 | 5 |
| OH | $340.32 | 1 |
| OK | $331.21 | 1 |
| OR | $361.65–$398.04 | 2 |
| PA | $341.02–$382.64 | 2 |
| PR | $369.90 | 1 |
| RI | $376.32 | 1 |
| SC | $341.61 | 1 |
| SD | $358.09 | 1 |
| TN | $332.96 | 1 |
| TX | $338.37–$383.04 | 8 |
| UT | $347.12 | 1 |
| VA | $357.73–$425.13 | 2 |
| VI | $369.90 | 1 |
| VT | $357.26 | 1 |
| WA | $380.42–$436.02 | 2 |
| WI | $344.92 | 1 |
| WV | $332.41 | 1 |
| WY | $363.36 | 1 |
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.
The exact Wyoming 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
112
- Locality
- Wyoming
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.46 | × 1.000 | 1.4600 |
| Practice expense | 9.13 | × 1.000 | 9.1300 |
| Malpractice | 0.39 | × 0.740 | 0.2886 |
| Total RVUs | 10.8786 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Wyoming$363.36
Office: (1.46 × 1 + 9.13 × 1 + 0.39 × 0.74) × $33.4009 = $363.36
Facility: (1.46 × 1 + 0.86 × 1 + 0.39 × 0.74) × $33.4009 = $87.13
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%).
How 46612 has changed in Wyoming
46612 · Office / nonfacility
$363.36
Effective 2026-10-01
The base rate is $53.86 higher than on 2025-10-01, moving from $309.50 to $363.36 (17.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$309.50changed to$363.36
- 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
- Malpractice GPCI 0.739 changed to 0.740
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$326.82changed to$309.50
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.03 changed to 7.78
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$321.49changed to$326.82
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$340.31changed to$321.49
- 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
- Malpractice GPCI 0.790 changed to 0.739
January 1, 2023
RVU23A
$359.49changed to$340.31
- 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
- Malpractice GPCI 0.841 changed to 0.790
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$358.74changed to$359.49
- 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.
January 1, 2021
RVU21A
$319.33changed to$358.74
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.03 changed to 8.47
- Malpractice GPCI 0.860 changed to 0.841
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$300.77changed to$319.33
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.52 changed to 7.03
- Malpractice GPCI 0.880 changed to 0.860
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$300.45changed to$300.77
- Malpractice RVU 0.36 changed to 0.37
Held through RVU19D.
January 1, 2019
RVU19A
$283.56changed to$300.45
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 6.06 changed to 6.52
Held through RVU19B.
January 1, 2018
RVU18AR1
$255.35changed to$283.56
- 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
- Malpractice GPCI 1.050 changed to 0.880
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$265.31changed to$255.35
- 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
- Malpractice GPCI 1.219 changed to 1.050
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$284.91changed to$265.31
- 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.
July 1, 2015
RVU15C
$283.49changed to$284.91
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$279.70changed to$283.49
- 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
- Malpractice GPCI 1.226 changed to 1.219
Held through RVU15B.
January 1, 2014
RVU14A
$294.37changed to$279.70
- 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
- Malpractice GPCI 1.233 changed to 1.226
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $294.37
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $363.36 | $87.13 | RVU26D |
| 2026-07-01 | $363.36 | $87.13 | RVU26C |
| 2026-04-01 | $363.36 | $87.13 | RVU26B |
| 2026-01-01 | $363.36 | $87.13 | RVU26A |
| 2025-10-01 | $309.50 | $90.19 | RVU25D |
| 2025-07-01 | $309.50 | $90.19 | RVU25C |
| 2025-04-01 | $309.50 | $90.19 | RVU25B |
| 2025-01-01 | $309.50 | $90.19 | RVU25A |
| 2024-10-01 | $326.82 | $91.81 | RVU24D |
| 2024-07-01 | $326.82 | $91.81 | RVU24C |
| 2024-04-01 | $326.82 | $91.81 | RVU24B |
| 2024-03-09 | $326.82 | $91.81 | RVU24AR |
| 2024-01-01 | $321.49 | $90.32 | RVU24A |
| 2023-10-01 | $340.31 | $92.93 | RVU23D |
| 2023-07-01 | $340.31 | $92.93 | RVU23C |
| 2023-04-01 | $340.31 | $92.93 | RVU23B |
| 2023-01-01 | $340.31 | $92.93 | RVU23A |
| 2022-10-01 | $359.49 | $95.79 | RVU22D |
| 2022-07-01 | $359.49 | $95.79 | RVU22C |
| 2022-04-01 | $359.49 | $95.79 | RVU22B |
| 2022-01-01 | $359.49 | $95.79 | RVU22A |
| 2021-10-01 | $358.74 | $95.65 | RVU21D |
| 2021-07-01 | $358.74 | $95.65 | RVU21C |
| 2021-04-01 | $358.74 | $95.65 | RVU21B |
| 2021-01-01 | $358.74 | $95.65 | RVU21A |
| 2020-10-01 | $319.33 | $97.74 | RVU20D |
| 2020-07-01 | $319.33 | $97.74 | RVU20C |
| 2020-04-01 | $319.33 | $97.74 | RVU20B |
| 2020-01-01 | $319.33 | $97.74 | RVU20A |
| 2019-10-01 | $300.77 | $97.51 | RVU19D |
| 2019-07-01 | $300.77 | $97.51 | RVU19C |
| 2019-04-01 | $300.45 | $97.19 | RVU19B |
| 2019-01-01 | $300.45 | $97.19 | RVU19A |
| 2018-10-01 | $283.56 | $97.44 | RVU18D |
| 2018-07-01 | $283.56 | $97.44 | RVU18C |
| 2018-04-01 | $283.56 | $97.44 | RVU18B |
| 2018-01-01 | $283.56 | $97.44 | RVU18AR1 |
| 2017-10-01 | $255.35 | $96.00 | RVU17D |
| 2017-07-01 | $255.35 | $96.00 | RVU17C |
| 2017-04-01 | $255.35 | $96.00 | RVU17B |
| 2017-01-01 | $255.35 | $96.00 | RVU17A |
| 2016-10-01 | $265.31 | $99.18 | RVU16D |
| 2016-07-01 | $265.31 | $99.18 | RVU16C |
| 2016-04-01 | $265.31 | $99.18 | RVU16B |
| 2016-01-01 | $265.31 | $99.18 | RVU16A |
| 2015-10-01 | $284.91 | $102.01 | RVU15D |
| 2015-07-01 | $284.91 | $102.01 | RVU15C |
| 2015-04-01 | $283.49 | $101.50 | RVU15B |
| 2015-01-01 | $283.49 | $101.50 | RVU15A |
| 2014-10-01 | $279.70 | $99.15 | RVU14D |
| 2014-07-01 | $279.70 | $99.15 | RVU14C |
| 2014-04-01 | $279.70 | $99.15 | RVU14B |
| 2014-01-01 | $279.70 | $99.15 | RVU14A |
| 2013-10-01 | $294.37 | $98.06 | RVU13D |
| 2013-07-01 | $294.37 | $98.06 | RVU13C |
| 2013-04-01 | $294.37 | $98.06 | RVU13B |
| 2013-01-01 | $294.37 | $98.06 | RVU13AR |
Where the Wyoming rate applies
Wyoming is a Medicare payment area, not a city. Our Census mapping connects it to 205 cities and communities in Wyoming. Some span more than one payment area; confirm with the service ZIP.
- Afton
- Albany
- Albin
- Alcova
- Alpine
- Alpine Northeast
- Alpine Northwest
- Alta
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
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