Billing code 46601: AnoscopyMedicare rate & RVUs in Oregon

Reports high-resolution examination of the anal canal, with brushing or washing specimens when performed, for evaluating suspected anal dysplasia or other abnormalities.

CMS RVU26DEffective Oct 1, 20262 payment localities2.2K Medicare services in 2024

Medicare pays $163.49–$176.90 for 46601 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.

$163.49–$176.90Office (non-facility)
$83.32–$87.47Hospital 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 46601 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oregon
  2. What 46601 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 46601 covers

A clinician uses an anoscope with high-resolution magnification to inspect the anal canal and identify abnormalities such as lesions suspicious for anal dysplasia. Brushing or washing specimens may be collected during the examination. Colorectal surgeons and other clinicians trained in high-resolution anoscopy commonly perform it in office or facility settings, including evaluation after abnormal anal cytology or in patients with HPV-related risk.

Select this code when high-resolution magnification is used and no biopsy is performed; specimen collection by brushing or washing is included when done. The record should support the indication, the high-resolution examination, findings, and any specimens collected. This has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, 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.

Where 46601 pays more and less in Oregon

46601 office and facility rates by payment locality
Payment localityOfficeFacility
Portland$176.90$87.47
Rest Of Oregon$163.49$83.32

How the 46601 rate is calculated

Each of 46601’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 · 46601

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.56Practice expense 3.20Malpractice 0.21

4.9700 adjusted RVUs×$33.4009 conversion factor=$166.00

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

Payment rules and modifiers for 46601

The CMS indicators that decide how 46601 is paid alongside other services.

CMS payment indicators · 46601

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

46601 without 51 · national office

$166.00

Anoscopy

46601-51 · Second procedure: 50%

$83.00

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

46601 compared with similar codes

Compare codes

46601 vs 46600 vs 46606 vs 46607: national Medicare rates

Swap in your local Medicare rate.

  • 46601
    Anoscopy · 1.56 wRVU
    $166.00
  • 46600
    Diagnostic anoscopy · 0.54 wRVU
    $128.93−$37.07
  • 46606
    Anoscopy biopsy · 1.17 wRVU
    $306.95+$140.95
  • 46607
    Anoscopy · 2.15 wRVU
    $230.80+$64.80

How to choose

46600Diagnostic anoscopy
Choose 46601 when the examination uses high-resolution magnification. 46600 describes diagnostic anoscopy without that feature.
46606Anoscopy biopsy
46606 is the biopsy option for anoscopy without high-resolution magnification. For high-resolution anoscopy with biopsy, consider 46607 instead.
46607Anoscopy
Both involve high-resolution anoscopy; 46607 includes biopsy, while 46601 is used when no biopsy is performed.

46601 billing questions

How is this different from 46600?

46601 is for diagnostic anoscopy using high-resolution magnification. Use 46600 for diagnostic anoscopy without that high-resolution examination.

Can brushing or washing be reported separately?

No. Collection of specimens by brushing or washing is included when performed as part of this examination.

Can a biopsy be included with 46601?

No. When biopsy is performed during high-resolution anoscopy, 46607 is the more appropriate code to evaluate.

Should modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are related endoscopies priced when performed together?

Endoscopy family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.

Can an assistant surgeon or co-surgeon be billed?

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 46601PPRRVU2026_Oct_nonQPP.csv, line 5,599 (RVU26D)

Open CMS sourceHow we calculate rates

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