$118.12
Choose 46601 when the examination uses high-resolution magnification. 46600 describes diagnostic anoscopy without that feature.
On this page
CMS RVU26D · Effective 2026-10-01
46601 Anoscopy Medicare reimbursement rates in Iowa
Reports high-resolution examination of the anal canal, with brushing or washing specimens when performed, for evaluating suspected anal dysplasia or other abnormalities. Compare 46601 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 46601 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$152.69
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$79.03
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Anorectal endoscopy
About 46601: High-resolution diagnostic anoscopy
Reports high-resolution examination of the anal canal, with brushing or washing specimens when performed, for evaluating suspected anal dysplasia or other abnormalities.
A clinician uses an anoscope with high-resolution magnification to inspect the anal canal and identify abnormalities such as lesions suspicious for anal dysplasia. Brushing or washing specimens may be collected during the examination. Colorectal surgeons and other clinicians trained in high-resolution anoscopy commonly perform it in office or facility settings, including evaluation after abnormal anal cytology or in patients with HPV-related risk.
Select this code when high-resolution magnification is used and no biopsy is performed; specimen collection by brushing or washing is included when done. The record should support the indication, the high-resolution examination, findings, and any specimens collected. This has 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. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 46601
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.56 · 31%
- Practice expense (office) RVU3.20 · 64%
- Malpractice RVU0.21 · 4%
2.2K
Medicare services in 2024 · #2385 by national volume
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.
46601 compared with similar codes
Office rates for Iowa, from the same CMS release.
$280.72
46606 is the biopsy option for anoscopy without high-resolution magnification. For high-resolution anoscopy with biopsy, consider 46607 instead.
$212.10
Both involve high-resolution anoscopy; 46607 includes biopsy, while 46601 is used when no biopsy is performed.
Compare 46601 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$152.69
Facility
$79.03
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 46601 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,599
- Code
- 46601
- Physician work
- 1.56
- Practice expense
- 3.20
- Malpractice
- 0.21
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.56 | × 1.000 | 1.5600 |
| Practice expense | 3.20 | × 0.915 | 2.9280 |
| Malpractice | 0.21 | × 0.397 | 0.0834 |
| Total RVUs | 4.5714 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$152.69
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.56 | 1 |
| Practice expense | 3.2 | 0.915 |
| Malpractice | 0.21 | 0.397 |
(1.56 × 1 + 3.2 × 0.915 + 0.21 × 0.397) × $33.4009 = $152.69
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.56 | 1 |
| Practice expense | 0.79 | 0.915 |
| Malpractice | 0.21 | 0.397 |
(1.56 × 1 + 0.79 × 0.915 + 0.21 × 0.397) × $33.4009 = $79.03
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
46601 billing questions
How is this different from 46600?
46601 is for diagnostic anoscopy using high-resolution magnification. Use 46600 for diagnostic anoscopy without that high-resolution examination.
Can brushing or washing be reported separately?
No. Collection of specimens by brushing or washing is included when performed as part of this examination.
Can a biopsy be included with 46601?
No. When biopsy is performed during high-resolution anoscopy, 46607 is the more appropriate code to evaluate.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are related endoscopies priced when performed together?
Endoscopy family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant surgeon or co-surgeon be billed?
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,59646500,,Injection into hemorrhoid(s),A,,1.70,8.75,,3.85,,0.27,10.72,5.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59746505,,Chemodenervation anal musc,A,,3.10,6.61,,3.73,,0.55,10.26,7.38,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59846600,,Diagnostic anoscopy spx,A,,0.54,3.24,,0.59,,0.08,3.86,1.21,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,59946601,,Diagnostic anoscopy,A,,1.56,3.20,,0.79,,0.21,4.97,2.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60046604,,Anoscopy and dilation,A,,1.00,19.51,,0.69,,0.18,20.69,1.87,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60146606,,Anoscopy and biopsy,A,,1.17,7.82,,0.76,,0.20,9.19,2.13,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60246607,,Diagnostic anoscopy & biopsy,A,,2.15,4.46,,0.94,,0.30,6.91,3.39,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136