$118.12
Choose 46600 for diagnostic anoscopy without foreign-body removal. Report 46608 when the anoscopic service includes removing foreign material.
On this page
CMS RVU26D · Effective 2026-10-01
46608 Anoscopy Medicare reimbursement rates in Iowa
Reports anoscopic removal of a foreign body from the anal canal or distal rectum under direct visualization, rather than diagnostic inspection or lesion treatment. Compare 46608 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 46608 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
$292.47
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$72.12
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 46608: Anoscopic foreign body removal
Reports anoscopic removal of a foreign body from the anal canal or distal rectum under direct visualization, rather than diagnostic inspection or lesion treatment.
A clinician advances an anoscope to inspect the anal canal and distal rectum, then removes a foreign body while viewing the site through the instrument. The service may be performed by a colorectal or general surgeon, or another qualified clinician who performs anorectal procedures, in an office or facility setting. The procedure is directed at retrieving foreign material, not sampling tissue or excising a tumor, polyp, or other lesion.
Report 46608 when the documented work includes anoscopic removal of a foreign body. The record should identify the foreign body, its location, the anoscopic visualization and removal performed, and the outcome. 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 service. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 46608
- 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 RVU1.27 · 13%
- Practice expense (office) RVU8.03 · 83%
- Malpractice RVU0.35 · 4%
34
Medicare services in 2024 · #5585 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.
46608 compared with similar codes
Office rates for Iowa, from the same CMS release.
$280.72
46606 describes anoscopy with tissue biopsy. It is not the code for retrieval of a foreign body.
$279.52
46610 is for anoscopic removal of a tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery; 46608 addresses foreign-body removal.
$332.97
46612 describes anoscopic lesion removal by snare. Use 46608 for removal of a foreign body, not a lesion.
Compare 46608 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
$292.47
Facility
$72.12
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 46608 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,603
- Code
- 46608
- Physician work
- 1.27
- Practice expense
- 8.03
- Malpractice
- 0.35
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.27 | × 1.000 | 1.2700 |
| Practice expense | 8.03 | × 0.915 | 7.3474 |
| Malpractice | 0.35 | × 0.397 | 0.1389 |
| Total RVUs | 8.7564 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$292.47
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.27 | 1 |
| Practice expense | 8.03 | 0.915 |
| Malpractice | 0.35 | 0.397 |
(1.27 × 1 + 8.03 × 0.915 + 0.35 × 0.397) × $33.4009 = $292.47
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.27 | 1 |
| Practice expense | 0.82 | 0.915 |
| Malpractice | 0.35 | 0.397 |
(1.27 × 1 + 0.82 × 0.915 + 0.35 × 0.397) × $33.4009 = $72.12
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.
46608 billing questions
How is 46608 different from diagnostic anoscopy?
46608 includes removal of a foreign body under anoscopic visualization. Use a diagnostic anoscopy code when the service is inspection without foreign-body removal.
Can 46608 be reported for removal of a polyp or other lesion?
No. This code is for foreign-body removal; lesion removal is represented by other anoscopy codes, with the applicable code depending on the removal method.
Can a diagnostic anoscopy be billed with 46608?
When related endoscopies are performed together, CMS endoscopy family pricing applies. The documentation should show the distinct services performed; do not assume separate payment for diagnostic inspection.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this service because the descriptor or anatomy does not support bilateral reporting.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 46608. 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.
5,60046604,,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
5,60346608,,Anoscopy remove for body,A,,1.27,8.03,,0.82,,0.35,9.65,2.44,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60446610,,Anoscopy remove lesion,A,,1.25,7.68,,0.80,,0.23,9.16,2.28,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60546611,,Anoscopy,A,,1.27,5.76,,0.77,,0.20,7.23,2.24,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60646612,,Anoscopy remove lesions,A,,1.46,9.13,,0.86,,0.39,10.98,2.71,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
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