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CMS RVU26D · Effective 2026-10-01

46606 Anoscopy biopsy Medicare reimbursement rates in New Mexico

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 New Mexico.

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 New Mexico?

New Mexico 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

$286.62

1 of 1 localities have a supported rate.

Payment area: New Mexico

One mapped payment locality.

Facility setting

$70.38

1 of 1 localities have a supported rate.

Payment area: New Mexico

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.

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 New Mexico, from the same CMS release.

46600

Diagnostic anoscopy

Standard visualization, optional washing

$120.48

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

46607

Anoscopy

High-resolution exam with biopsy

$220.45

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

46610

Anoscopy

Hot forceps or bipolar cautery

$286.21

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

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

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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 New Mexico.

PPRRVU2026_Oct_nonQPP.csv

5,601

Code
46606
Physician work
1.17
Practice expense
7.82
Malpractice
0.20

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office / nonfacility calculation for 46606 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0001.1700
Practice expense7.82× 0.9177.1709
Malpractice0.20× 1.2010.2402
Total RVUs8.5811
Conversion factor× 33.4009

Office / nonfacility rate, New Mexico$286.62

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.171
Practice expense7.820.917
Malpractice0.21.201

(1.17 × 1 + 7.82 × 0.917 + 0.2 × 1.201) × $33.4009 = $286.62

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.171
Practice expense0.760.917
Malpractice0.21.201

(1.17 × 1 + 0.76 × 0.917 + 0.2 × 1.201) × $33.4009 = $70.38

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.

RVUs for 46606PPRRVU2026_Oct_nonQPP.csv, line 5,601 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)