CPT code 46615: Anoscopy, lesion ablation2026 Medicare rate & RVUs
Anoscopy with lesion ablation treats one or more anal canal lesions under direct visualization when tissue is destroyed rather than removed for pathology.
Medicare pays $191.72 for 46615 nationally in the office and $83.84 in a hospital or facility. Local office rates run $169.15–$253.92.
Medicare rate · 46615
Anoscopy, lesion ablation
- Work RVUs
- 1.46
- Total RVUs
- 5.74
- Global days
- 000
National rate · 2026
$191.72
Office setting, before claim adjustments.
See every locality for 46615 →Billed by an NP, PA or therapist? →
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 10 sections
What 46615 covers
This service combines examination of the anal canal through an anoscope with destruction of one or more identified lesions. It may be used to treat anal condyloma or dysplastic lesions when the clinician selects an ablative approach, such as cautery or another method that destroys the target tissue. Colorectal surgeons and other clinicians trained in anorectal procedures commonly perform it in an office or procedure-room setting, or in a facility. It is distinct from a diagnostic anoscopy and from procedures that remove a lesion for examination as a specimen.
Report the service when documentation supports anoscopic visualization and treatment by ablation, and identifies the lesion or lesions treated. Do not select it merely because a lesion was observed or sampled; biopsy and removal methods have separate codes. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 46615 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$169.15 to $253.92
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $171.68 | $77.29 |
| Alaska | $221.79 | $106.89 |
| Arizona | $186.50 | $81.96 |
| Arkansas | $169.15 | $76.48 |
| Atlanta, GA | $195.45 | $85.84 |
| Austin, TX | $198.90 | $84.76 |
| Bakersfield, CA | $202.96 | $84.71 |
| Baltimore area, MD | $204.09 | $88.33 |
| Beaumont, TX | $178.99 | $80.81 |
| Brazoria, TX | $189.34 | $82.43 |
| Chicago, IL | $201.83 | $93.40 |
| Chico, CA | $202.35 | $84.10 |
| Colorado | $199.47 | $84.68 |
| Connecticut | $204.64 | $88.44 |
| Dallas, TX | $190.62 | $83.17 |
| Delaware | $189.63 | $83.03 |
| Detroit, MI | $191.77 | $87.67 |
| East St. Louis, IL | $187.96 | $88.70 |
| El Centro, CA | $202.38 | $84.14 |
| Fort Lauderdale, FL | $199.16 | $89.87 |
| Fort Worth, TX | $189.35 | $82.98 |
| Fresno, CA | $202.35 | $84.10 |
| Galveston, TX | $189.95 | $82.82 |
| Hanford, CA | $202.35 | $84.10 |
| Hawaii, Guam, HI | $207.39 | $84.73 |
| Houston, TX | $193.80 | $86.67 |
| Idaho | $177.15 | $77.90 |
| Indiana | $178.19 | $78.18 |
| Iowa | $175.94 | $77.22 |
| Kansas | $175.19 | $77.66 |
| Kentucky | $176.04 | $80.13 |
| King County, WA | $223.73 | $91.36 |
| Los Angeles, CA | $216.24 | $88.61 |
| Madera, CA | $202.35 | $84.10 |
| Manhattan, NY | $220.98 | $95.61 |
| Marin County, CA | $248.30 | $96.18 |
| Merced, CA | $202.35 | $84.10 |
| Metropolitan Boston, MA | $219.32 | $90.51 |
| Metropolitan Kansas City, MO | $183.27 | $81.96 |
| Metropolitan Philadelphia, PA | $199.53 | $87.22 |
| Metropolitan St. Louis, MO | $185.21 | $82.50 |
| Miami, FL | $208.02 | $95.71 |
| Minnesota | $190.73 | $79.71 |
| Mississippi | $170.99 | $78.11 |
| Modesto, CA | $202.35 | $84.10 |
| Montana | $191.71 | $83.82 |
| Napa, CA | $234.57 | $92.38 |
| Nebraska | $176.89 | $77.31 |
| Nevada | $190.69 | $82.69 |
| New Hampshire | $196.42 | $84.11 |
| New Mexico | $181.85 | $82.92 |
| New Orleans, LA | $184.65 | $83.13 |
| North Carolina | $180.08 | $79.42 |
| North Dakota | $187.55 | $79.67 |
| Northern New Jersey | $217.02 | $91.87 |
| NYC suburbs and Long Island, NY | $226.55 | $98.27 |
| Ohio | $179.95 | $81.45 |
| Oklahoma | $175.61 | $79.27 |
| Oxnard, CA | $215.18 | $87.66 |
| Portland, OR | $205.80 | $85.94 |
| Poughkeepsie and northern NYC suburbs, NY | $208.30 | $90.17 |
| Puerto Rico | $193.11 | $84.04 |
| Queens, NY | $222.68 | $95.16 |
| Redding, CA | $202.35 | $84.10 |
| Rest of California | $202.35 | $84.10 |
| Rest of Florida | $189.27 | $86.13 |
| Rest of Georgia | $178.39 | $82.15 |
| Rest of Illinois | $183.84 | $85.34 |
| Rest of Louisiana | $175.79 | $80.32 |
| Rest of Maine | $178.19 | $78.94 |
| Rest of Maryland | $193.26 | $84.09 |
| Rest of Massachusetts | $198.28 | $84.68 |
| Rest of Michigan | $180.80 | $82.30 |
| Rest of Missouri | $172.78 | $79.78 |
| Rest of New Jersey | $206.86 | $89.05 |
| Rest of New York | $182.84 | $80.35 |
| Rest of Oregon | $189.09 | $81.64 |
| Rest of Pennsylvania | $180.19 | $81.15 |
| Rest of Texas | $184.11 | $81.72 |
| Rest of Washington | $197.88 | $84.28 |
| Rhode Island | $196.38 | $84.93 |
| Riverside, CA | $204.62 | $86.38 |
| Sacramento, CA | $212.38 | $86.91 |
| Salinas, CA | $211.59 | $86.55 |
| San Benito County, CA | $253.92 | $98.35 |
| San Diego, CA | $216.62 | $87.59 |
| San Francisco, CA | $248.06 | $95.94 |
| San Luis Obispo, CA | $208.19 | $85.31 |
| Santa Clara County, CA | $252.94 | $97.37 |
| Santa Cruz, CA | $218.72 | $87.64 |
| Santa Maria, CA | $212.40 | $86.60 |
| Santa Rosa, CA | $220.92 | $88.44 |
| South Carolina | $180.34 | $80.65 |
| South Dakota | $187.06 | $79.18 |
| Southern Maine, ME | $187.91 | $81.00 |
| Stockton, CA | $202.35 | $84.10 |
| Suburban Chicago, IL | $201.15 | $90.35 |
| Tennessee | $176.10 | $78.04 |
| Utah | $182.85 | $81.44 |
| Vallejo, CA | $234.23 | $92.04 |
| Vermont | $186.90 | $80.09 |
| Virgin Islands, VI | $193.11 | $84.04 |
| Virginia | $187.35 | $81.30 |
| Visalia, CA | $202.35 | $84.10 |
| Washington, DC area | $219.34 | $92.26 |
| West Virginia | $176.94 | $83.18 |
| Wisconsin | $181.16 | $77.80 |
| Wyoming | $189.90 | $82.01 |
| Yuba City, CA | $202.35 | $84.10 |
46615 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.
$169.15
$228.14
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 | $221.79 | 1 |
| AL | $171.68 | 1 |
| AR | $169.15 | 1 |
| AZ | $186.50 | 1 |
| CA | $202.35–$253.92 | 29 |
| CO | $199.47 | 1 |
| CT | $204.64 | 1 |
| DC | $219.34 | 1 |
| DE | $189.63 | 1 |
| FL | $189.27–$208.02 | 3 |
| GA | $178.39–$195.45 | 2 |
| GU | $207.39 | 1 |
| HI | $207.39 | 1 |
| IA | $175.94 | 1 |
| ID | $177.15 | 1 |
| IL | $183.84–$201.83 | 4 |
| IN | $178.19 | 1 |
| KS | $175.19 | 1 |
| KY | $176.04 | 1 |
| LA | $175.79–$184.65 | 2 |
| MA | $198.28–$219.32 | 2 |
| MD | $193.26–$219.34 | 3 |
| ME | $178.19–$187.91 | 2 |
| MI | $180.80–$191.77 | 2 |
| MN | $190.73 | 1 |
| MO | $172.78–$185.21 | 3 |
| MS | $170.99 | 1 |
| MT | $191.71 | 1 |
| NC | $180.08 | 1 |
| ND | $187.55 | 1 |
| NE | $176.89 | 1 |
| NH | $196.42 | 1 |
| NJ | $206.86–$217.02 | 2 |
| NM | $181.85 | 1 |
| NV | $190.69 | 1 |
| NY | $182.84–$226.55 | 5 |
| OH | $179.95 | 1 |
| OK | $175.61 | 1 |
| OR | $189.09–$205.80 | 2 |
| PA | $180.19–$199.53 | 2 |
| PR | $193.11 | 1 |
| RI | $196.38 | 1 |
| SC | $180.34 | 1 |
| SD | $187.06 | 1 |
| TN | $176.10 | 1 |
| TX | $178.99–$198.90 | 8 |
| UT | $182.85 | 1 |
| VA | $187.35–$219.34 | 2 |
| VI | $193.11 | 1 |
| VT | $186.90 | 1 |
| WA | $197.88–$223.73 | 2 |
| WI | $181.16 | 1 |
| WV | $176.94 | 1 |
| WY | $189.90 | 1 |
How the 46615 rate is calculated
Each of 46615’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 · 46615
RVUs × geographic indexes × conversion factor
Work1.46
1.46 RVUs× 1.000 GPCI
Practice expense4.07
4.07 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
5.7400
Conversion factor
$33.4009
Medicare rate
$191.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 46615
The CMS indicators that decide how 46615 is paid alongside other services.
CMS payment indicators · 46615
Anoscopy, lesion ablation
| 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
46615 without 51 · national office
$191.72
Anoscopy, lesion ablation
46615-51 · Second procedure: 50%
$95.86
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%).
46615 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 46600Diagnostic anoscopyStandard visualization, optional washing
- 46600 represents diagnostic anoscopy. Report 46615 when the examination includes ablation of one or more lesions.
- 46606Anoscopy biopsyBiopsy performed
- 46606 represents anoscopy with biopsy. Use 46615 for lesion destruction by ablation, not tissue sampling.
- 46610AnoscopyHot forceps or bipolar cautery
- 46610 describes anoscopic lesion removal by its specified technique. Use 46615 when the documented treatment destroys lesion tissue by ablation.
- 46614AnoscopyBleeding control
- 46614 is for anoscopic control of bleeding. Use 46615 when the purpose and work are lesion ablation rather than hemostasis.
46615 billing questions
How is this different from diagnostic anoscopy?
This code is for anoscopy that includes ablation of one or more lesions. Use a diagnostic anoscopy code when the examination is performed without lesion ablation.
Can this code be reported when a lesion is biopsied?
The service described here is ablation, not biopsy. If tissue is sampled or removed for pathology, select the code that matches the documented biopsy or removal technique rather than treating this as a biopsy code.
How does it differ from anoscopic lesion removal?
Choose an anoscopic removal code when the clinician removes a lesion using the technique specified by that code. This code describes destruction of lesion tissue by ablation.
What documentation supports reporting it?
Document anoscopic visualization, the lesion or lesions treated, and the ablative treatment performed. The note should distinguish ablation from biopsy or physical removal.
What happens when another related endoscopy is performed at the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The claim should reflect the services actually performed and their relationship.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for the service; co-surgeons 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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