CPT 46600
Global 000 ActiveDiagnostic anoscopy spx
CPT 46600 Billing & Documentation Guide
CPT code 46600 (Diagnostic anoscopy spx) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.54, a non-facility practice expense RVU of 3.24, and a malpractice RVU of 0.08, a total non-facility RVU of 3.86 and facility RVU of 1.21. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $133.63, though rates vary from $112.37 to $177.5 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 46600, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 46600 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 46600 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 46600
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.54 | 0.54 |
| Practice Expense RVU | 3.24 | 0.59 |
| Malpractice RVU | 0.08 | 0.08 |
| Total RVU | 3.86 | 1.21 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 46600
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $148.18 | $43.45 | $138.38 - $177.5 | 29 |
| Florida | $131.82 | $43.01 | $125.51 - $137.45 | 3 |
| Georgia | $124.5 | $40.06 | $117.75 - $131.25 | 2 |
| Illinois | $127.78 | $42.25 | $121.02 - $134.04 | 4 |
| Michigan | $123.41 | $40.31 | $119.86 - $126.97 | 2 |
| North Carolina | $120.71 | $38.13 | $120.71 - $120.71 | 1 |
| New York | $143.25 | $44.51 | $122.72 - $152.83 | 5 |
| Ohio | $119.53 | $38.72 | $119.53 - $119.53 | 1 |
| Pennsylvania | $127.05 | $40.36 | $119.91 - $134.2 | 2 |
| Texas | $127.16 | $40.02 | $119 - $134.94 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 46600
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 46600 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00731 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00732 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00740 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00810 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00811 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00812 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00813 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00902 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 46600
What does CPT code 46600 mean? +
CPT code 46600 represents: Diagnostic anoscopy spx. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 46600? +
The 2026 Medicare national average non-facility payment for CPT 46600 is $133.63. Rates range from $112.37 to $177.5 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 46600? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 46600? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 18, 2026.
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