$128.23
46600 represents diagnostic anoscopy. Choose 46614 when the procedure includes active work to control bleeding.
On this page
CMS RVU26D · Effective 2026-10-01
46614 Anoscopy Medicare reimbursement rates in Wyoming
Anoscopy with hemostasis is reported when a clinician uses an anoscope to identify and control active bleeding in the anal canal or lower rectum. Compare 46614 office and facility rates across CMS payment localities in Wyoming.
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 46614 in Wyoming?
Wyoming 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
$181.98
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$60.07
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 procedure
About 46614: Anoscopy with bleeding control
Anoscopy with hemostasis is reported when a clinician uses an anoscope to identify and control active bleeding in the anal canal or lower rectum.
This procedure combines examination through an anoscope with treatment to stop bleeding. It may be performed by a colorectal or general surgeon, or another clinician experienced in anorectal procedures, in an office or facility setting. The service is appropriate when bleeding requires active control during the anoscopic procedure, rather than inspection alone or tissue sampling alone.
Report the code when the record identifies the bleeding site and documents the hemostatic work performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed in the same session, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this service. An assistant at surgery is not paid under the statutory restriction; co-surgeons and team surgery are not permitted.
CMS billing rules for 46614
- 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 RVU0.98 · 18%
- Practice expense (office) RVU4.35 · 79%
- Malpractice RVU0.16 · 3%
853
Medicare services in 2024 · #3093 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.
46614 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$305.22
46606 is for anoscopy with biopsy. Use 46614 for hemostasis; biopsy alone does not make the service bleeding control.
$303.95
46610 describes removal of a single lesion through anoscopy. 46614 is selected for control of bleeding, not lesion removal as the service.
$189.90
46615 is for anoscopic ablation of lesion tissue. 46614 is for hemostasis when control of bleeding is the procedure performed.
Compare 46614 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
Wyoming** →
Office / nonfacility
$181.98
Facility
$60.07
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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 46614 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,607
- Code
- 46614
- Physician work
- 0.98
- Practice expense
- 4.35
- Malpractice
- 0.16
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.000 | 0.9800 |
| Practice expense | 4.35 | × 1.000 | 4.3500 |
| Malpractice | 0.16 | × 0.740 | 0.1184 |
| Total RVUs | 5.4484 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$181.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 4.35 | 1 |
| Malpractice | 0.16 | 0.74 |
(0.98 × 1 + 4.35 × 1 + 0.16 × 0.74) × $33.4009 = $181.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 0.7 | 1 |
| Malpractice | 0.16 | 0.74 |
(0.98 × 1 + 0.7 × 1 + 0.16 × 0.74) × $33.4009 = $60.07
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.
46614 billing questions
When should this be reported instead of diagnostic anoscopy?
Use this code when the anoscopic service includes active treatment to control bleeding. Diagnostic inspection without hemostasis is represented by 46600.
Can diagnostic anoscopy be billed separately with bleeding control?
The anoscopy is part of the bleeding-control service. Document the findings and hemostatic work rather than separately reporting a diagnostic examination for the same procedure.
How should related endoscopies performed in the same session be priced?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The record should identify each service performed during the session.
Should modifier 50 be appended?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
Can an assistant or co-surgeon be billed?
An assistant at surgery is not paid under the statutory restriction. Co-surgeons and team surgery are not permitted for this service.
What documentation supports reporting this code?
Document the bleeding source or location, the anoscopic findings, and the method or work used to achieve hemostasis.
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.
5,60446610,,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
5,60846615,,Anoscopy,A,,1.46,4.07,,0.84,,0.21,5.74,2.51,0,000,0.00,0.00,0.00,3,0,1,0,0,9,46600,33.4009,09,0,99,0.00,0.00,0.00
5,60946700,,Repair of anal stricture,A,,9.56,8.00,NA,8.00,,1.59,19.15,19.15,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,61046705,,Repair of anal stricture,A,,7.24,8.09,NA,8.09,,1.93,17.26,17.26,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,