Billing code 46610: AnoscopyMedicare rate & RVUs
Reports anoscopic removal of an anal canal lesion using hot biopsy forceps or bipolar cautery, rather than biopsy alone or another removal technique.
Medicare pays $305.95 for 46610 nationally in the office and $76.15 in a hospital or facility. Local office rates run $266.06–$420.36.
Medicare rate · 46610
Anoscopy
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- Work RVUs
- 1.25
- Total RVUs
- 9.16
- Global days
- 000
National rate · 2026
$305.95
Office setting, before claim adjustments.
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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 46610 covers
A clinician examines the anal canal through an anoscope and removes a tumor, polyp, or other lesion using hot biopsy forceps or bipolar cautery. Colorectal surgeons and other clinicians who perform anorectal procedures may provide this service in an office or facility setting. The code is specific to removal with these cautery techniques; a lesion sampled for diagnosis without removal is a different service, as is removal by snare or laser.
Select this code when the procedure record supports both anoscopic access and removal using the specified technique. Document the lesion treated and how it was removed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons 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 46610 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
$266.06 to $420.36
109 of 109 payment localities
46610 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.
$266.06
$374.04
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 | $340.05 | 1 |
| AL | $270.55 | 1 |
| AR | $266.06 | 1 |
| AZ | $296.89 | 1 |
| CA | $327.72–$420.36 | 29 |
| CO | $321.19 | 1 |
| CT | $328.15 | 1 |
| DC | $354.74 | 1 |
| DE | $302.31 | 1 |
| FL | $298.53–$328.22 | 3 |
| GA | $279.72–$311.73 | 2 |
| GU | $337.86 | 1 |
| HI | $337.86 | 1 |
| IA | $279.52 | 1 |
| ID | $281.38 | 1 |
| IL | $287.96–$319.10 | 4 |
| IN | $283.28 | 1 |
| KS | $277.52 | 1 |
| KY | $276.83 | 1 |
| LA | $276.13–$291.86 | 2 |
| MA | $318.66–$356.58 | 2 |
| MD | $308.82–$354.74 | 3 |
| ME | $282.53–$300.81 | 2 |
| MI | $284.63–$302.24 | 2 |
| MN | $307.98 | 1 |
| MO | $270.35–$293.65 | 3 |
| MS | $268.29 | 1 |
| MT | $305.94 | 1 |
| NC | $285.99 | 1 |
| ND | $301.39 | 1 |
| NE | $281.42 | 1 |
| NH | $315.51 | 1 |
| NJ | $331.97–$350.15 | 2 |
| NM | $286.21 | 1 |
| NV | $304.93 | 1 |
| NY | $290.84–$363.69 | 5 |
| OH | $283.70 | 1 |
| OK | $276.79 | 1 |
| OR | $302.64–$333.13 | 2 |
| PA | $284.50–$318.70 | 2 |
| PR | $308.66 | 1 |
| RI | $314.38 | 1 |
| SC | $285.30 | 1 |
| SD | $300.85 | 1 |
| TN | $279.05 | 1 |
| TX | $282.32–$320.04 | 8 |
| UT | $289.78 | 1 |
| VA | $299.33–$354.74 | 2 |
| VI | $308.66 | 1 |
| VT | $299.59 | 1 |
| WA | $318.25–$364.86 | 2 |
| WI | $289.86 | 1 |
| WV | $275.66 | 1 |
| WY | $303.95 | 1 |
How the 46610 rate is calculated
Each of 46610’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 · 46610
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.25Practice expense 7.68Malpractice 0.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 46610
The CMS indicators that decide how 46610 is paid alongside other services.
CMS payment indicators · 46610
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 | 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
46610 without 51 · national office
$305.95
Anoscopy
46610-51 · Second procedure: 50%
$152.98
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%).
46610 compared with similar codes
Compare codes
46610 vs 46600 vs 46606 vs 46611 vs 46615: national Medicare rates
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How to choose
- 46600Diagnostic anoscopy
- 46600 describes diagnostic anoscopy. Choose this code when the anoscopic procedure includes lesion removal with hot biopsy forceps or bipolar cautery.
- 46606Anoscopy biopsy
- 46606 is for anoscopic biopsy. This code describes removal using hot biopsy forceps or bipolar cautery, not tissue sampling alone.
- 46611Anoscopy
- 46611 is used when the lesion is removed by snare technique. This code applies when hot biopsy forceps or bipolar cautery is used.
- 46615Anoscopy
- 46615 describes anoscopic lesion ablation. This code is for lesion removal by hot biopsy forceps or bipolar cautery.
46610 billing questions
When should this code be chosen instead of an anoscopy with biopsy?
Use this code when the lesion is removed with hot biopsy forceps or bipolar cautery. An anoscopic biopsy code describes sampling tissue rather than the removal reported here.
How does this differ from anoscopic removal by snare or laser?
The method determines the code: this code is for hot biopsy forceps or bipolar cautery. Snare and laser removal are represented by separate technique-specific codes.
Is diagnostic anoscopy separately reported with lesion removal?
When related endoscopies are performed together, CMS applies endoscopy-family pricing. The diagnostic examination is part of the same procedural session, not an unrelated service.
Should modifier 50 be used for lesions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What should the procedure note establish?
Document the anal canal lesion treated and that removal was performed through an anoscope using hot biopsy forceps or bipolar cautery.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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
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