CPT code 46615: Anoscopy, lesion ablation2026 Medicare rate & RVUs in Iowa

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 Iowa, Medicare pays $175.94 for 46615 in the office and $77.22 when it’s performed in a hospital or facility.

$175.94Office (non-facility)
$77.22Hospital or facility
−8.2%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 Iowa
  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 Iowa 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. Iowa pays $175.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

46615 in Iowa vs other payment areas
  1. Iowa · this page$175.94
  2. Los Angeles, CA · California$216.24+$40.30
  3. Washington, DC area · District of Columbia$219.34+$43.40
  4. Miami, FL · Florida$208.02+$32.08
  5. Chicago, IL · Illinois$201.83+$25.89
  6. Manhattan, NY · New York$220.98+$45.04
  7. Alaska · Alaska$221.79+$45.85

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

Every other payment area

46615 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$171.68$77.29
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

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
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 Iowa 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

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 46615 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0001.4600
Practice expense4.07× 0.9153.7241
Malpractice0.21× 0.3970.0834
Total RVUs5.2674
Conversion factor× 33.4009

Office rate, Iowa$175.94

Office: (1.46 × 1 + 4.07 × 0.915 + 0.21 × 0.397) × $33.4009 = $175.94

Facility: (1.46 × 1 + 0.84 × 0.915 + 0.21 × 0.397) × $33.4009 = $77.22

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

How 46615 has changed in Iowa

46615 · Office / nonfacility

$175.94

Effective 2026-10-01

The base rate is $20.95 higher than on 2025-10-01, moving from $154.99 to $175.94 (13.5%).

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

    $154.99changed to$175.94

    • 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
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $162.84changed to$154.99

    • 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

    $160.18changed to$162.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $166.53changed to$160.18

    • 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
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $174.44changed to$166.53

    • 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
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $171.31changed to$174.44

    • 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

    $151.95changed to$171.31

    • 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
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $142.88changed to$151.95

    • 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
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $135.67changed to$142.88

    • 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

    $133.21changed to$135.67

    • 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
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $133.40changed to$133.21

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.33 changed to 2.31
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $134.52changed to$133.40

    • 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

    $133.85changed to$134.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $132.95changed to$133.85

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.33 changed to 2.35
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $134.30changed to$132.95

    • 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
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $134.30

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$175.94$77.22RVU26D
2026-07-01$175.94$77.22RVU26C
2026-04-01$175.94$77.22RVU26B
2026-01-01$175.94$77.22RVU26A
2025-10-01$154.99$81.45RVU25D
2025-07-01$154.99$81.45RVU25C
2025-04-01$154.99$81.45RVU25B
2025-01-01$154.99$81.45RVU25A
2024-10-01$162.84$83.52RVU24D
2024-07-01$162.84$83.52RVU24C
2024-04-01$162.84$83.52RVU24B
2024-03-09$162.84$83.52RVU24AR
2024-01-01$160.18$82.15RVU24A
2023-10-01$166.53$83.89RVU23D
2023-07-01$166.53$83.89RVU23C
2023-04-01$166.53$83.89RVU23B
2023-01-01$166.53$83.89RVU23A
2022-10-01$174.44$85.92RVU22D
2022-07-01$174.44$85.92RVU22C
2022-04-01$174.44$85.92RVU22B
2022-01-01$174.44$85.92RVU22A
2021-10-01$171.31$85.86RVU21D
2021-07-01$171.31$85.86RVU21C
2021-04-01$171.31$85.86RVU21B
2021-01-01$171.31$85.86RVU21A
2020-10-01$151.95$87.79RVU20D
2020-07-01$151.95$87.79RVU20C
2020-04-01$151.95$87.79RVU20B
2020-01-01$151.95$87.79RVU20A
2019-10-01$142.88$87.31RVU19D
2019-07-01$142.88$87.31RVU19C
2019-04-01$142.88$87.31RVU19B
2019-01-01$142.88$87.31RVU19A
2018-10-01$135.67$87.67RVU18D
2018-07-01$135.67$87.67RVU18C
2018-04-01$135.67$87.67RVU18B
2018-01-01$135.67$87.67RVU18AR1
2017-10-01$133.21$87.57RVU17D
2017-07-01$133.21$87.57RVU17C
2017-04-01$133.21$87.57RVU17B
2017-01-01$133.21$87.57RVU17A
2016-10-01$133.40$87.52RVU16D
2016-07-01$133.40$87.52RVU16C
2016-04-01$133.40$87.52RVU16B
2016-01-01$133.40$87.52RVU16A
2015-10-01$134.52$88.16RVU15D
2015-07-01$134.52$88.16RVU15C
2015-04-01$133.85$87.72RVU15B
2015-01-01$133.85$87.72RVU15A
2014-10-01$132.95$87.58RVU14D
2014-07-01$132.95$87.58RVU14C
2014-04-01$132.95$87.58RVU14B
2014-01-01$132.95$87.58RVU14A
2013-10-01$134.30$85.41RVU13D
2013-07-01$134.30$85.41RVU13C
2013-04-01$134.30$85.41RVU13B
2013-01-01$134.30$85.41RVU13AR

Price 46615 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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 IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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