Billing code 46611: AnoscopyMedicare rate & RVUs

Anoscopy with snare excision removes a tumor, polyp, or other lesion from the anal canal when the clinician uses snare technique.

CMS RVU26DEffective Oct 1, 2026109 payment localities187 Medicare services in 2024

Medicare pays $241.49 for 46611 nationally in the office and $74.82 in a hospital or facility. Local office rates run $211.12–$328.09.

Medicare rate · 46611

Anoscopy

Swap in your local Medicare rate.

Work RVUs
1.27
Total RVUs
7.23
Global days
000

National rate · 2026

$241.49

Office setting, before claim adjustments.

See every locality for 46611 → · 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
  1. Medicare rate
  2. What 46611 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 46611 covers

The clinician examines the anal canal with an anoscope and removes a tumor, polyp, or other lesion using a snare. Colorectal surgeons and gastroenterologists commonly perform this focused anorectal procedure in an office procedure room or facility setting. It is distinct from diagnostic-only anoscopy and from removal by other techniques.

Document the lesion treated and the snare technique used. Do not separately report diagnostic anoscopy as though it were a separate service when it is part of the removal. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate for this anatomy and service. Medicare does not pay an assistant at surgery for this code; 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 46611 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

$211.12 to $328.09

$211.12$269.61$328.09
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

46611 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$214.54$68.70
Alaska*$272.20$94.70
Arizona$234.56$73.06
Arkansas$211.12$67.95
Atlanta$246.04$76.70
Austin$251.97$75.63
Bakersfield$258.15$75.48
Baltimore/Surr. Cntys$257.79$78.96
Beaumont$223.70$72.03
Brazoria$238.63$73.46

46611 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.

$211.12

$292.84

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

View every state and territory as a table
46611 office rate range by state
State / territoryOffice rate rangeLocalities
AK$272.201
AL$214.541
AR$211.121
AZ$234.561
CA$257.58–$328.0929
CO$252.851
CT$258.551
DC$278.781
DE$238.721
FL$236.38–$259.593
GA$221.99–$246.042
GU$265.031
HI$265.031
IA$221.111
ID$222.581
IL$228.51–$252.144
IN$224.011
KS$219.711
KY$219.571
LA$219.08–$231.052
MA$251.01–$279.822
MD$243.67–$278.783
ME$223.57–$237.292
MI$225.61–$239.342
MN$242.361
MO$214.77–$232.273
MS$213.001
MT$241.481
NC$226.191
ND$237.521
NE$222.521
NH$248.541
NJ$261.53–$275.402
NM$226.861
NV$240.571
NY$229.89–$286.295
OH$224.801
OK$219.411
OR$238.73–$261.812
PA$225.35–$251.432
PR$243.501
RI$247.921
SC$225.861
SD$237.051
TN$220.891
TX$223.70–$251.978
UT$229.261
VA$236.25–$278.782
VI$243.501
VT$236.261
WA$250.64–$286.062
WI$228.791
WV$219.161
WY$239.751

How the 46611 rate is calculated

Each of 46611’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 · 46611

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.27Practice expense 5.76Malpractice 0.20

7.2300 adjusted RVUs×$33.4009 conversion factor=$241.49

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 46611

The CMS indicators that decide how 46611 is paid alongside other services.

CMS payment indicators · 46611

Anoscopy

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

46611 without 51 · national office

$241.49

Anoscopy

46611-51 · Second procedure: 50%

$120.75

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

46611 compared with similar codes

Compare codes

46611 vs 46600 vs 46610 vs 46612 vs 46615: national Medicare rates

Swap in your local Medicare rate.

  • 46611
    Anoscopy · 1.27 wRVU
    $241.49
  • 46600
    Diagnostic anoscopy · 0.54 wRVU
    $128.93−$112.56
  • 46610
    Anoscopy · 1.25 wRVU
    $305.95+$64.46
  • 46612
    Anoscopy · 1.46 wRVU
    $366.74+$125.25
  • 46615
    Anoscopy · 1.46 wRVU
    $191.72−$49.77

How to choose

46600Diagnostic anoscopy
46600 is for diagnostic anoscopy, with or without specimen collection by brushing or washing. Select 46611 when the clinician removes a lesion using a snare.
46610Anoscopy
46610 describes anoscopic removal of a foreign body. Code 46611 is for snare removal of a tumor, polyp, or other lesion.
46612Anoscopy
Both codes involve anoscopic lesion removal, but 46611 specifies snare technique; 46612 specifies hot biopsy forceps or bipolar cautery.
46615Anoscopy
46615 is for lesion ablation. Use 46611 when the documented treatment is snare removal rather than ablation.

46611 billing questions

When should this code be selected instead of diagnostic anoscopy?

Use this code when the clinician removes a tumor, polyp, or other lesion with a snare. Diagnostic-only examination without snare removal is reported with 46600.

Can diagnostic anoscopy be billed separately on the same encounter?

The examination performed to locate and treat the lesion is part of the snare-removal service, rather than a separate diagnostic anoscopy.

How does this differ from anoscopic lesion removal with cautery?

This code identifies snare technique. Code 46612 is for lesion removal using hot biopsy forceps or bipolar cautery.

Should modifier 50 be used for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not describe this anorectal service.

What staffing and same-day care rules affect payment?

The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

What happens when related endoscopies are performed during the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. The record should identify the services performed and the lesion-removal technique.

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 46611PPRRVU2026_Oct_nonQPP.csv, line 5,605 (RVU26D)

Open CMS sourceHow we calculate rates

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