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

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 Tennessee, Medicare pays $176.10 for 46615 in the office and $78.04 when it’s performed in a hospital or facility.

$176.10Office (non-facility)
$78.04Hospital or facility
−8.1%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 Tennessee
  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 Tennessee 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. Tennessee pays $176.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

46615 in Tennessee vs other payment areas
  1. Tennessee · this page$176.10
  2. Los Angeles, CA · California$216.24+$40.14
  3. Washington, DC area · District of Columbia$219.34+$43.24
  4. Miami, FL · Florida$208.02+$31.92
  5. Chicago, IL · Illinois$201.83+$25.73
  6. Manhattan, NY · New York$220.98+$44.88
  7. Alaska · Alaska$221.79+$45.69

Other areas in Tennessee 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.

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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 46615 in Tennessee
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0001.4600
Practice expense4.07× 0.9093.6996
Malpractice0.21× 0.5370.1128
Total RVUs5.2724
Conversion factor× 33.4009

Office rate, Tennessee$176.10

Office: (1.46 × 1 + 4.07 × 0.909 + 0.21 × 0.537) × $33.4009 = $176.10

Facility: (1.46 × 1 + 0.84 × 0.909 + 0.21 × 0.537) × $33.4009 = $78.04

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, Tennessee
Same family
46600Diagnostic anoscopy, standard visualization, optional washingDiagnostic anoscopy without lesion ablation.$117.84
46601Anoscopy, high-resolution, without biopsyDiagnostic anoscopy with a distinct examination approach.$153.03
46606Anoscopy biopsy, biopsy performedAnoscopy with biopsy rather than ablation.$280.09
46607Anoscopy, high-resolution exam with biopsyDiagnostic anoscopy with biopsy.$212.60
46610Anoscopy, hot forceps or bipolar cauteryAnoscopic removal of a lesion using a specified technique.$279.05
46612Anoscopy, lesion removal by excisionAnoscopic removal of multiple lesions using a specified technique.$332.96
46614Anoscopy, bleeding controlAnoscopy performed to control bleeding.$167.67

How 46615 has changed in Tennessee

46615 · Office / nonfacility

$176.10

Effective 2026-10-01

The base rate is $22.45 higher than on 2025-10-01, moving from $153.65 to $176.10 (14.6%).

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

    $153.65changed to$176.10

    • 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 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $161.40changed to$153.65

    • 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

    $158.77changed to$161.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $165.05changed to$158.77

    • 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 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544

  5. January 1, 2023

    RVU23A

    $172.92changed to$165.05

    • 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 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $169.83changed to$172.92

    • 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

    $151.55changed to$169.83

    • 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
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $143.17changed to$151.55

    • 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
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $136.12changed to$143.17

    • 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. April 1, 2018

    RVU18B

    No ratechanged to$136.12

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$176.10$78.04RVU26D
2026-07-01$176.10$78.04RVU26C
2026-04-01$176.10$78.04RVU26B
2026-01-01$176.10$78.04RVU26A
2025-10-01$153.65$81.49RVU25D
2025-07-01$153.65$81.49RVU25C
2025-04-01$153.65$81.49RVU25B
2025-01-01$153.65$81.49RVU25A
2024-10-01$161.40$83.56RVU24D
2024-07-01$161.40$83.56RVU24C
2024-04-01$161.40$83.56RVU24B
2024-03-09$161.40$83.56RVU24AR
2024-01-01$158.77$82.20RVU24A
2023-10-01$165.05$83.86RVU23D
2023-07-01$165.05$83.86RVU23C
2023-04-01$165.05$83.86RVU23B
2023-01-01$165.05$83.86RVU23A
2022-10-01$172.92$85.87RVU22D
2022-07-01$172.92$85.87RVU22C
2022-04-01$172.92$85.87RVU22B
2022-01-01$172.92$85.87RVU22A
2021-10-01$169.83$85.79RVU21D
2021-07-01$169.83$85.79RVU21C
2021-04-01$169.83$85.79RVU21B
2021-01-01$169.83$85.79RVU21A
2020-10-01$151.55$88.10RVU20D
2020-07-01$151.55$88.10RVU20C
2020-04-01$151.55$88.10RVU20B
2020-01-01$151.55$88.10RVU20A
2019-10-01$143.17$87.97RVU19D
2019-07-01$143.17$87.97RVU19C
2019-04-01$143.17$87.97RVU19B
2019-01-01$143.17$87.97RVU19A
2018-10-01$136.12$88.44RVU18D
2018-07-01$136.12$88.44RVU18C
2018-04-01$136.12$88.44RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 46615 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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 TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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