$127.70–$140.54
46600 is diagnostic anoscopy without the examination-under-anesthesia service. Choose 45990 when anesthesia is needed to complete a reliable anorectal examination.
On this page
CMS RVU26D · Effective 2026-10-01
45990 Anorectal exam Medicare reimbursement rates in Oregon
A surgeon examines the anal canal and distal rectum under anesthesia when pain, spasm, or limited access prevents an adequate diagnostic office examination. Compare 45990 office and facility rates across CMS payment localities in Oregon.
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 45990 in Oregon?
Oregon 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
No supported rate
Facility setting
$95.95–$100.71
2 of 2 localities have a supported rate.
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.
Surgical anorectal
About 45990: Anorectal examination under anesthesia
A surgeon examines the anal canal and distal rectum under anesthesia when pain, spasm, or limited access prevents an adequate diagnostic office examination.
This service is a diagnostic examination of the anal canal and distal rectum performed under anesthesia, typically by a colorectal or general surgeon in an operating room or other procedural setting. It is useful when pain, sphincter spasm, or inability to tolerate positioning prevents a reliable office assessment—for example, when evaluating persistent anorectal pain, bleeding, or a suspected lesion. The code represents the diagnostic examination, not treatment of a prolapse, narrowing, or obstruction.
Report it when the record supports why an examination under anesthesia was needed, what areas and findings were assessed, and the diagnostic purpose. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery, co-surgeon, and team-surgery payment requires documentation supporting medical necessity.
CMS billing rules for 45990
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU1.76 · 59%
- Practice expense (office) RVU0.87 · 29%
- Malpractice RVU0.35 · 12%
3.9K
Medicare services in 2024 · #2014 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.
45990 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
45905 is an anal sphincter dilation procedure. 45990 is diagnostic and does not represent dilation.
No office rate
45910 treats rectal narrowing by dilation; 45990 documents a diagnostic anorectal examination rather than treatment of a stricture.
Compare 45990 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
Portland →
Office / nonfacility
Unavailable
Facility
$100.71
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$95.95
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45990 billing questions
When is 45990 more appropriate than office anoscopy?
Use 45990 when an adequate diagnostic anorectal examination requires anesthesia, such as when pain or spasm prevents a reliable office examination. An office anoscopy is appropriate when the patient can tolerate that examination.
Does 45990 describe treatment of a finding?
No. It describes a diagnostic examination. A service that treats a prolapse, anal narrowing, or rectal obstruction has its own procedure code and must be supported by the operative record.
What documentation supports reporting 45990?
Document the reason an examination under anesthesia was needed, the diagnostic purpose, the areas examined, and the findings. The record should make clear why an office examination was inadequate.
How is same-session multiple-procedure payment handled?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment also require supporting documentation.
What care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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.
5,56545905,,Dilation of anal sphincter,A,,2.29,2.35,NA,2.35,,0.42,5.06,5.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56645910,,Dilation of rectal narrowing,A,,2.78,2.37,NA,2.37,,0.48,5.63,5.63,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56745915,,Remove rectal obstruction,A,,3.11,8.35,,3.21,,0.62,12.08,6.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56845990,,Surg dx exam anorectal,A,,1.76,0.87,NA,0.87,,0.35,2.98,2.98,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56945999,,Unlisted procedure rectum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57046020,,Placement of seton,A,,1.81,1.15,NA,1.15,,0.36,3.32,3.32,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,57146030,,Removal anal seton oth mrk,A,,1.44,6.82,,0.73,,0.24,8.50,2.41,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00