CPT 46601
Global 000 ActiveDiagnostic anoscopy
CPT 46601 Billing & Documentation Guide
CPT code 46601 (Diagnostic anoscopy) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.56, a non-facility practice expense RVU of 3.2, and a malpractice RVU of 0.21, a total non-facility RVU of 4.97 and facility RVU of 2.56. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $170.72, though rates vary from $147.53 to $215.72 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 46601, 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 46601 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 46601 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 46601
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.56 | 1.56 |
| Practice Expense RVU | 3.2 | 0.79 |
| Malpractice RVU | 0.21 | 0.21 |
| Total RVU | 4.97 | 2.56 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 46601
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 | $184.25 | $89 | $173.89 - $215.72 | 29 |
| Florida | $173 | $92.23 | $164.83 - $181.11 | 3 |
| Georgia | $162.55 | $85.75 | $155.81 - $169.28 | 2 |
| Illinois | $168.97 | $91.19 | $160.65 - $175.98 | 4 |
| Michigan | $162.34 | $86.76 | $157.61 - $167.07 | 2 |
| North Carolina | $156.31 | $81.21 | $156.31 - $156.31 | 1 |
| New York | $183.35 | $93.55 | $158.58 - $195.55 | 5 |
| Ohio | $156.76 | $83.27 | $156.76 - $156.76 | 1 |
| Pennsylvania | $164.77 | $85.92 | $156.85 - $172.68 | 2 |
| Texas | $164.13 | $84.88 | $155.89 - $171.51 | 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 46601
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 46601 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 46601
What does CPT code 46601 mean? +
CPT code 46601 represents: Diagnostic anoscopy. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 46601? +
The 2026 Medicare national average non-facility payment for CPT 46601 is $170.72. Rates range from $147.53 to $215.72 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 46601? +
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 46601? +
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 April 17, 2026.
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