$117.21
Use 46600 for diagnostic anoscopy without tissue biopsy. When tissue is sampled during standard anoscopy, use 46606.
On this page
CMS RVU26D · Effective 2026-10-01
46606 Anoscopy biopsy Medicare reimbursement rates in Kansas
Report this service when standard anoscopy is used to inspect the anal canal and obtain one or more tissue biopsies for pathologic examination. Compare 46606 office and facility rates across CMS payment localities in Kansas.
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 46606 in Kansas?
Kansas 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
$278.57
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$65.39
1 of 1 localities have a supported rate.
Payment area: Kansas
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 46606: Anoscopy with tissue biopsy
Report this service when standard anoscopy is used to inspect the anal canal and obtain one or more tissue biopsies for pathologic examination.
A clinician examines the anal canal through an anoscope and takes one or more tissue samples from an abnormal area for pathologic evaluation. Colorectal surgeons and gastroenterologists commonly perform this service in an office or procedure room when inspection identifies tissue that needs histologic assessment, such as a suspicious mucosal lesion or ulcer. The biopsy distinguishes this service from diagnostic anoscopy without tissue sampling and from procedures that remove or ablate a lesion.
Report the code when the documented service includes tissue biopsy; record the finding and sampling site. Same-day preoperative and postoperative care is included in its 0-day global period. When related endoscopies are performed together, endoscopy family pricing applies, so the procedures are priced under the family rules rather than each being treated as an unrelated service. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 46606
- 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 RVU1.17 · 13%
- Practice expense (office) RVU7.82 · 85%
- Malpractice RVU0.20 · 2%
1.8K
Medicare services in 2024 · #2535 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.
46606 compared with similar codes
Office rates for Kansas, from the same CMS release.
$211.53
46607 includes biopsy during high-resolution anoscopy. Choose 46606 when the biopsy is performed with standard anoscopy.
$277.52
46610 describes removal of a lesion during anoscopy. Use 46606 when tissue is sampled for pathology without reporting lesion removal.
Compare 46606 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
Kansas →
Office / nonfacility
$278.57
Facility
$65.39
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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 46606 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,601
- Code
- 46606
- Physician work
- 1.17
- Practice expense
- 7.82
- Malpractice
- 0.20
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 7.82 | × 0.904 | 7.0693 |
| Malpractice | 0.20 | × 0.504 | 0.1008 |
| Total RVUs | 8.3401 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$278.57
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 7.82 | 0.904 |
| Malpractice | 0.2 | 0.504 |
(1.17 × 1 + 7.82 × 0.904 + 0.2 × 0.504) × $33.4009 = $278.57
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 0.76 | 0.904 |
| Malpractice | 0.2 | 0.504 |
(1.17 × 1 + 0.76 × 0.904 + 0.2 × 0.504) × $33.4009 = $65.39
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.
46606 billing questions
When should this be reported instead of 46600?
Report 46606 when anoscopy includes tissue biopsy. Use 46600 for diagnostic inspection without tissue biopsy.
How does 46606 differ from 46607?
Both include biopsy, but 46607 is for diagnostic anoscopy using high-resolution magnification. Report 46606 for biopsy with standard anoscopy.
Can the biopsy be reported separately from the anoscopy?
The biopsy is part of this anoscopy service; do not report a separate code for the tissue sampling itself.
Should modifier 50 be appended for bilateral findings?
No. Bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What happens when related endoscopies are performed in the same session?
CMS applies endoscopy family pricing to related endoscopies performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
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.
5,59846600,,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
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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958