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CMS RVU26D · Effective 2026-10-01

46606 Anoscopy biopsy Medicare reimbursement rates in Michigan

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 Michigan.

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 Michigan?

Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$285.09–$302.40

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $17.31 per service.

Facility setting

$69.80–$74.84

2 of 2 localities have a supported rate.

Lowest: Rest Of Michigan

Highest: Detroit

A spread of $5.04 per service.

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.

Find 46606 in your payment locality →

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 Michigan, from the same CMS release.

46600

Diagnostic anoscopy

Standard visualization, optional washing

$119.86–$126.97

Use 46600 for diagnostic anoscopy without tissue biopsy. When tissue is sampled during standard anoscopy, use 46606.

46607

Anoscopy

High-resolution exam with biopsy

$219.13–$232.46

46607 includes biopsy during high-resolution anoscopy. Choose 46606 when the biopsy is performed with standard anoscopy.

46610

Anoscopy

Hot forceps or bipolar cautery

$284.63–$302.24

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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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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.

RVUs for 46606PPRRVU2026_Oct_nonQPP.csv, line 5,601 (RVU26D)