Billing code 46600: Diagnostic anoscopyMedicare rate & RVUs
A clinician examines the anal canal with an anoscope for diagnostic purposes, optionally collecting cells or secretions by brushing or washing.
Medicare pays $128.93 for 46600 nationally in the office and $40.42 in a hospital or facility. Local office rates run $112.37–$177.50.
Medicare rate · 46600
Diagnostic anoscopy
Swap in your local Medicare rate.
- Work RVUs
- 0.54
- Total RVUs
- 3.86
- Global days
- 000
National rate · 2026
$128.93
Office setting, before claim adjustments.
See every locality for 46600 → · 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.
On this page 10 sections
What 46600 covers
A clinician inserts a short anoscope to inspect the anal canal and nearby distal rectum. Colorectal surgeons, gastroenterologists, and other clinicians may perform the exam in an office or outpatient setting to evaluate symptoms such as anal pain or bleeding, or findings such as suspected hemorrhoids, fissures, or an anal canal lesion. Collection of a specimen by brushing or washing can be part of this diagnostic service.
Report 46600 when the anoscopy is diagnostic and does not include a separately defined service such as biopsy, dilation, or lesion removal. Document the indication, examination findings, and any brushing or washing performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment 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 46600 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
$112.37 to $177.50
109 of 109 payment localities
46600 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$112.37
$157.94
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 | $143.78 | 1 |
| AL | $114.24 | 1 |
| AR | $112.37 | 1 |
| AZ | $125.19 | 1 |
| CA | $138.38–$177.50 | 29 |
| CO | $135.48 | 1 |
| CT | $138.18 | 1 |
| DC | $149.47 | 1 |
| DE | $127.45 | 1 |
| FL | $125.51–$137.45 | 3 |
| GA | $117.75–$131.25 | 2 |
| GU | $142.63 | 1 |
| HI | $142.63 | 1 |
| IA | $118.12 | 1 |
| ID | $118.86 | 1 |
| IL | $121.02–$134.04 | 4 |
| IN | $119.65 | 1 |
| KS | $117.21 | 1 |
| KY | $116.69 | 1 |
| LA | $116.37–$122.91 | 2 |
| MA | $134.41–$150.37 | 2 |
| MD | $130.19–$149.47 | 3 |
| ME | $119.26–$126.97 | 2 |
| MI | $119.86–$126.97 | 2 |
| MN | $130.18 | 1 |
| MO | $113.92–$123.74 | 3 |
| MS | $113.19 | 1 |
| MT | $128.92 | 1 |
| NC | $120.71 | 1 |
| ND | $127.34 | 1 |
| NE | $118.93 | 1 |
| NH | $133.03 | 1 |
| NJ | $139.86–$147.56 | 2 |
| NM | $120.48 | 1 |
| NV | $128.59 | 1 |
| NY | $122.72–$152.83 | 5 |
| OH | $119.53 | 1 |
| OK | $116.75 | 1 |
| OR | $127.70–$140.54 | 2 |
| PA | $119.91–$134.20 | 2 |
| PR | $130.08 | 1 |
| RI | $132.55 | 1 |
| SC | $120.30 | 1 |
| SD | $127.15 | 1 |
| TN | $117.84 | 1 |
| TX | $119.00–$134.94 | 8 |
| UT | $122.16 | 1 |
| VA | $126.30–$149.47 | 2 |
| VI | $130.08 | 1 |
| VT | $126.53 | 1 |
| WA | $134.26–$153.91 | 2 |
| WI | $122.53 | 1 |
| WV | $115.90 | 1 |
| WY | $128.23 | 1 |
How the 46600 rate is calculated
Each of 46600’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 · 46600
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.54Practice expense 3.24Malpractice 0.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46600
The CMS indicators that decide how 46600 is paid alongside other services.
CMS payment indicators · 46600
Diagnostic anoscopy
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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
46600 without 51 · national office
$128.93
Diagnostic anoscopy
46600-51 · Second procedure: 50%
$64.47
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%).
46600 compared with similar codes
Compare codes
46600 vs 46601 vs 46606 vs 46607 vs 46604: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 46601Anoscopy
- Choose 46601 when high-resolution magnification is used; 46600 describes standard diagnostic anoscopy.
- 46606Anoscopy biopsy
- Choose 46606 when one or more biopsies are taken during anoscopy. Brushing or washing collection alone remains within 46600.
- 46607Anoscopy
- Choose 46607 when high-resolution magnification and biopsy are both performed; 46600 is for standard diagnostic inspection.
- 46604Anoscopy
- Choose 46604 when the anoscopy includes dilation. 46600 describes diagnostic inspection without that added service.
46600 billing questions
When should 46600 be used instead of 46601?
Use 46600 for standard diagnostic anoscopy. Use 46601 when the examination uses high-resolution magnification.
Can brushing or washing be reported separately?
No. Specimen collection by brushing or washing is included in the diagnostic anoscopy service.
Which code applies if the clinician takes a biopsy?
Use 46606 for anoscopy with biopsy without high-resolution magnification, or 46607 when high-resolution magnification and biopsy are performed.
Does 46600 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
How does the multiple-procedure rule affect 46600?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
Can 46600 be billed with bilateral or surgical-team modifiers?
Bilateral adjustment is inappropriate for this code. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment 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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