Billing code 46610: AnoscopyMedicare rate & RVUs in Nevada

Reports anoscopic removal of an anal canal lesion using hot biopsy forceps or bipolar cautery, rather than biopsy alone or another removal technique.

CMS RVU26DEffective Oct 1, 20261 payment locality138 Medicare services in 2024

Medicare pays $304.93 for 46610 in the office in Nevada (Nevada**). Which amount applies depends on the service address.

$304.93Office (non-facility)
$74.90Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 46610 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nevada
  2. What 46610 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 46610 covers

A clinician examines the anal canal through an anoscope and removes a tumor, polyp, or other lesion using hot biopsy forceps or bipolar cautery. Colorectal surgeons and other clinicians who perform anorectal procedures may provide this service in an office or facility setting. The code is specific to removal with these cautery techniques; a lesion sampled for diagnosis without removal is a different service, as is removal by snare or laser.

Select this code when the procedure record supports both anoscopic access and removal using the specified technique. Document the lesion treated and how it was removed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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.

46610 in Nevada**

46610 office and facility rates by payment locality
Payment localityOfficeFacility
Nevada**$304.93$74.90

How the 46610 rate is calculated

Each of 46610’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 · 46610

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.25Practice expense 7.68Malpractice 0.23

9.1600 adjusted RVUs×$33.4009 conversion factor=$305.95

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

Payment rules and modifiers for 46610

The CMS indicators that decide how 46610 is paid alongside other services.

CMS payment indicators · 46610

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

46610 without 51 · national office

$305.95

Anoscopy

46610-51 · Second procedure: 50%

$152.98

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

46610 compared with similar codes

Compare codes

46610 vs 46600 vs 46606 vs 46611 vs 46615: national Medicare rates

Swap in your local Medicare rate.

  • 46610
    Anoscopy · 1.25 wRVU
    $305.95
  • 46600
    Diagnostic anoscopy · 0.54 wRVU
    $128.93−$177.02
  • 46606
    Anoscopy biopsy · 1.17 wRVU
    $306.95+$1.00
  • 46611
    Anoscopy · 1.27 wRVU
    $241.49−$64.46
  • 46615
    Anoscopy · 1.46 wRVU
    $191.72−$114.23

How to choose

46600Diagnostic anoscopy
46600 describes diagnostic anoscopy. Choose this code when the anoscopic procedure includes lesion removal with hot biopsy forceps or bipolar cautery.
46606Anoscopy biopsy
46606 is for anoscopic biopsy. This code describes removal using hot biopsy forceps or bipolar cautery, not tissue sampling alone.
46611Anoscopy
46611 is used when the lesion is removed by snare technique. This code applies when hot biopsy forceps or bipolar cautery is used.
46615Anoscopy
46615 describes anoscopic lesion ablation. This code is for lesion removal by hot biopsy forceps or bipolar cautery.

46610 billing questions

When should this code be chosen instead of an anoscopy with biopsy?

Use this code when the lesion is removed with hot biopsy forceps or bipolar cautery. An anoscopic biopsy code describes sampling tissue rather than the removal reported here.

How does this differ from anoscopic removal by snare or laser?

The method determines the code: this code is for hot biopsy forceps or bipolar cautery. Snare and laser removal are represented by separate technique-specific codes.

Is diagnostic anoscopy separately reported with lesion removal?

When related endoscopies are performed together, CMS applies endoscopy-family pricing. The diagnostic examination is part of the same procedural session, not an unrelated service.

Should modifier 50 be used for lesions on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

What should the procedure note establish?

Document the anal canal lesion treated and that removal was performed through an anoscope using hot biopsy forceps or bipolar cautery.

Can an assistant surgeon or co-surgeon be reported?

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 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 46610PPRRVU2026_Oct_nonQPP.csv, line 5,604 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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