$132.55
46600 describes diagnostic anoscopy. Choose this code when the anoscopic procedure includes lesion removal with hot biopsy forceps or bipolar cautery.
On this page
CMS RVU26D · Effective 2026-10-01
46610 Anoscopy Medicare reimbursement rates in Rhode Island
Reports anoscopic removal of an anal canal lesion using hot biopsy forceps or bipolar cautery, rather than biopsy alone or another removal technique. Compare 46610 office and facility rates across CMS payment localities in Rhode Island.
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 46610 in Rhode Island?
Rhode Island 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
$314.38
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$77.00
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Anorectal endoscopy
About 46610: Anoscopy with lesion removal by cautery
Reports anoscopic removal of an anal canal lesion using hot biopsy forceps or bipolar cautery, rather than biopsy alone or another removal technique.
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.
CMS billing rules for 46610
- 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 RVU1.25 · 14%
- Practice expense (office) RVU7.68 · 84%
- Malpractice RVU0.23 · 3%
138
Medicare services in 2024 · #4618 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.
46610 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$315.59
46606 is for anoscopic biopsy. This code describes removal using hot biopsy forceps or bipolar cautery, not tissue sampling alone.
$247.92
46611 is used when the lesion is removed by snare technique. This code applies when hot biopsy forceps or bipolar cautery is used.
$196.38
46615 describes anoscopic lesion ablation. This code is for lesion removal by hot biopsy forceps or bipolar cautery.
Compare 46610 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
Rhode Island →
Office / nonfacility
$314.38
Facility
$77.00
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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 46610 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
5,604
- Code
- 46610
- Physician work
- 1.25
- Practice expense
- 7.68
- Malpractice
- 0.23
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.019 | 1.2737 |
| Practice expense | 7.68 | × 1.033 | 7.9334 |
| Malpractice | 0.23 | × 0.892 | 0.2052 |
| Total RVUs | 9.4123 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$314.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1.019 |
| Practice expense | 7.68 | 1.033 |
| Malpractice | 0.23 | 0.892 |
(1.25 × 1.019 + 7.68 × 1.033 + 0.23 × 0.892) × $33.4009 = $314.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1.019 |
| Practice expense | 0.8 | 1.033 |
| Malpractice | 0.23 | 0.892 |
(1.25 × 1.019 + 0.8 × 1.033 + 0.23 × 0.892) × $33.4009 = $77.00
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.
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 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.
5,60146606,,Anoscopy and biopsy,A,,1.17,7.82,,0.76,,0.20,9.19,2.13,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60246607,,Diagnostic anoscopy & biopsy,A,,2.15,4.46,,0.94,,0.30,6.91,3.39,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60346608,,Anoscopy remove for body,A,,1.27,8.03,,0.82,,0.35,9.65,2.44,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60446610,,Anoscopy remove lesion,A,,1.25,7.68,,0.80,,0.23,9.16,2.28,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60546611,,Anoscopy,A,,1.27,5.76,,0.77,,0.20,7.23,2.24,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60646612,,Anoscopy remove lesions,A,,1.46,9.13,,0.86,,0.39,10.98,2.71,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60746614,,Anoscopy control bleeding,A,,0.98,4.35,,0.70,,0.16,5.49,1.84,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537