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CPT code 46615: Anoscopy, lesion ablation2026 Medicare rate & RVUs in Washington, DC area

Anoscopy with lesion ablation treats one or more anal canal lesions under direct visualization when tissue is destroyed rather than removed for pathology.

CMS RVU26DEffective Oct 1, 2026One payment locality270 Medicare services in 2024

In Washington, DC area, Medicare pays $219.34 for 46615 in the office and $92.26 when it’s performed in a hospital or facility.

$219.34Office (non-facility)
$92.26Hospital or facility
+14.4%vs the national office rate ($191.72)

Check a contract rate as a % of Medicare · 46615 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 46615 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 46615 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 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.

How Washington, DC area compares for 46615

Across 109 of 109 payment localities, the office rate for 46615 runs from $169.15 in Arkansas to $253.92 in San Benito County, CA. Washington, DC area pays $219.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

46615 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$219.34
  2. Los Angeles, CA · California$216.24−$3.10
  3. Miami, FL · Florida$208.02−$11.32
  4. Chicago, IL · Illinois$201.83−$17.51
  5. Manhattan, NY · New York$220.98+$1.64
  6. Alaska · Alaska$221.79+$2.45
  7. Alabama · Alabama$171.68−$47.66

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

46615 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$169.15$76.48
ArizonaArizona$186.50$81.96
Bakersfield, CACalifornia$202.96$84.71
Chico, CACalifornia$202.35$84.10
El Centro, CACalifornia$202.38$84.14
Fresno, CACalifornia$202.35$84.10
Hanford, CACalifornia$202.35$84.10
Madera, CACalifornia$202.35$84.10

46615 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.

$169.15

$228.14

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

View every state and territory as a table
46615 office rate range by state
State / territoryOffice rate rangeLocalities
AK$221.791
AL$171.681
AR$169.151
AZ$186.501
CA$202.35–$253.9229
CO$199.471
CT$204.641
DC$219.341
DE$189.631
FL$189.27–$208.023
GA$178.39–$195.452
GU$207.391
HI$207.391
IA$175.941
ID$177.151
IL$183.84–$201.834
IN$178.191
KS$175.191
KY$176.041
LA$175.79–$184.652
MA$198.28–$219.322
MD$193.26–$219.343
ME$178.19–$187.912
MI$180.80–$191.772
MN$190.731
MO$172.78–$185.213
MS$170.991
MT$191.711
NC$180.081
ND$187.551
NE$176.891
NH$196.421
NJ$206.86–$217.022
NM$181.851
NV$190.691
NY$182.84–$226.555
OH$179.951
OK$175.611
OR$189.09–$205.802
PA$180.19–$199.532
PR$193.111
RI$196.381
SC$180.341
SD$187.061
TN$176.101
TX$178.99–$198.908
UT$182.851
VA$187.35–$219.342
VI$193.111
VT$186.901
WA$197.88–$223.732
WI$181.161
WV$176.941
WY$189.901

See 46615 in every payment locality

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

Office or facility?

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.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,608

Code
46615
Physician work
1.46
Practice expense
4.07
Malpractice
0.21

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 46615 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0541.5388
Practice expense4.07× 1.1784.7945
Malpractice0.21× 1.1130.2337
Total RVUs6.5670
Conversion factor× 33.4009

Office rate, Washington, DC area$219.34

Office: (1.46 × 1.054 + 4.07 × 1.178 + 0.21 × 1.113) × $33.4009 = $219.34

Facility: (1.46 × 1.054 + 0.84 × 1.178 + 0.21 × 1.113) × $33.4009 = $92.26

Open 46615 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 46615

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

Codes related to 46615
CodeHow it relatesOffice range, Washington, DC area
Same family
46600Diagnostic anoscopy, standard visualization, optional washingDiagnostic anoscopy without lesion ablation.$149.47
46601Anoscopy, high-resolution, without biopsyDiagnostic anoscopy with a distinct examination approach.$188.63
46606Anoscopy biopsy, biopsy performedAnoscopy with biopsy rather than ablation.$356.31
46607Anoscopy, high-resolution exam with biopsyDiagnostic anoscopy with biopsy.$262.33
46610Anoscopy, hot forceps or bipolar cauteryAnoscopic removal of a lesion using a specified technique.$354.74
46612Anoscopy, lesion removal by excisionAnoscopic removal of multiple lesions using a specified technique.$425.13
46614Anoscopy, bleeding controlAnoscopy performed to control bleeding.$211.60

How 46615 has changed in Washington, DC area

46615 · Office / nonfacility

$219.34

Effective 2026-10-01

The base rate is $25.17 higher than on 2025-10-01, moving from $194.17 to $219.34 (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

    $194.17changed to$219.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.50 changed to 1.46
    • Practice expense RVU 3.50 changed to 4.07
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $204.18changed to$194.17

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.61 changed to 3.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $200.85changed to$204.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $212.17changed to$200.85

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.66 changed to 3.61
    • Malpractice RVU 0.19 changed to 0.21
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $226.63changed to$212.17

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.81 changed to 3.66
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $222.02changed to$226.63

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.67 changed to 3.81
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $193.81changed to$222.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.89 changed to 3.67
    • Malpractice RVU 0.21 changed to 0.19
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $180.29changed to$193.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.61 changed to 2.89
    • Malpractice RVU 0.23 changed to 0.21
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $171.48changed to$180.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.38 changed to 2.61
    • Malpractice RVU 0.26 changed to 0.23

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $169.09changed to$171.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.31 changed to 2.38
    • Malpractice RVU 0.28 changed to 0.26
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $169.80changed to$169.09

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.33 changed to 2.31
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $171.28changed to$169.80

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.35 changed to 2.33

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $170.43changed to$171.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $168.84changed to$170.43

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.33 changed to 2.35
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $171.07changed to$168.84

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.61 changed to 2.33
    • Malpractice RVU 0.29 changed to 0.28
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $171.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$219.34$92.26RVU26D
2026-07-01$219.34$92.26RVU26C
2026-04-01$219.34$92.26RVU26B
2026-01-01$219.34$92.26RVU26A
2025-10-01$194.17$98.16RVU25D
2025-07-01$194.17$98.16RVU25C
2025-04-01$194.17$98.16RVU25B
2025-01-01$194.17$98.16RVU25A
2024-10-01$204.18$100.62RVU24D
2024-07-01$204.18$100.62RVU24C
2024-04-01$204.18$100.62RVU24B
2024-03-09$204.18$100.62RVU24AR
2024-01-01$200.85$98.98RVU24A
2023-10-01$212.17$101.92RVU23D
2023-07-01$212.17$101.92RVU23C
2023-04-01$212.17$101.92RVU23B
2023-01-01$212.17$101.92RVU23A
2022-10-01$226.63$106.01RVU22D
2022-07-01$226.63$106.01RVU22C
2022-04-01$226.63$106.01RVU22B
2022-01-01$226.63$106.01RVU22A
2021-10-01$222.02$105.58RVU21D
2021-07-01$222.02$105.58RVU21C
2021-04-01$222.02$105.58RVU21B
2021-01-01$222.02$105.58RVU21A
2020-10-01$193.81$107.45RVU20D
2020-07-01$193.81$107.45RVU20C
2020-04-01$193.81$107.45RVU20B
2020-01-01$193.81$107.45RVU20A
2019-10-01$180.29$106.46RVU19D
2019-07-01$180.29$106.46RVU19C
2019-04-01$180.29$106.46RVU19B
2019-01-01$180.29$106.46RVU19A
2018-10-01$171.48$107.71RVU18D
2018-07-01$171.48$107.71RVU18C
2018-04-01$171.48$107.71RVU18B
2018-01-01$171.48$107.71RVU18AR1
2017-10-01$169.09$108.11RVU17D
2017-07-01$169.09$108.11RVU17C
2017-04-01$169.09$108.11RVU17B
2017-01-01$169.09$108.11RVU17A
2016-10-01$169.80$108.11RVU16D
2016-07-01$169.80$108.11RVU16C
2016-04-01$169.80$108.11RVU16B
2016-01-01$169.80$108.11RVU16A
2015-10-01$171.28$108.93RVU15D
2015-07-01$171.28$108.93RVU15C
2015-04-01$170.43$108.39RVU15B
2015-01-01$170.43$108.39RVU15A
2014-10-01$168.84$107.69RVU14D
2014-07-01$168.84$107.69RVU14C
2014-04-01$168.84$107.69RVU14B
2014-01-01$168.84$107.69RVU14A
2013-10-01$171.07$105.04RVU13D
2013-07-01$171.07$105.04RVU13C
2013-04-01$171.07$105.04RVU13B
2013-01-01$171.07$105.04RVU13AR

Price 46615 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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

Show the CMS file lines behind this rate
RVUs for 46615PPRRVU2026_Oct_nonQPP.csv, line 5,608 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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