CPT 46606
Global 000 ActiveAnoscopy and biopsy
CPT 46606 Billing & Documentation Guide
CPT code 46606 (Anoscopy and biopsy) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.17, a non-facility practice expense RVU of 7.82, and a malpractice RVU of 0.2, a total non-facility RVU of 9.19 and facility RVU of 2.13. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $318.19, though rates vary from $266.89 to $423.6 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 46606, 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 46606 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 46606 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 46606
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.17 | 1.17 |
| Practice Expense RVU | 7.82 | 0.76 |
| Malpractice RVU | 0.2 | 0.2 |
| Total RVU | 9.19 | 2.13 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 46606
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 | $353.17 | $74.14 | $329.59 - $423.6 | 29 |
| Florida | $314.15 | $77.55 | $298.82 - $327.88 | 3 |
| Georgia | $296.31 | $71.35 | $280.03 - $312.59 | 2 |
| Illinois | $304.36 | $76.51 | $287.99 - $319.44 | 4 |
| Michigan | $293.75 | $72.32 | $285.09 - $302.4 | 2 |
| North Carolina | $287.04 | $67.03 | $287.04 - $287.04 | 1 |
| New York | $341.4 | $78.33 | $291.91 - $364.55 | 5 |
| Ohio | $284.28 | $68.99 | $284.28 - $284.28 | 1 |
| Pennsylvania | $302.42 | $71.44 | $285.17 - $319.66 | 2 |
| Texas | $302.65 | $70.49 | $282.97 - $321.42 | 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 46606
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 46606 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 46606
What does CPT code 46606 mean? +
CPT code 46606 represents: Anoscopy and biopsy. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 46606? +
The 2026 Medicare national average non-facility payment for CPT 46606 is $318.19. Rates range from $266.89 to $423.6 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 46606? +
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 46606? +
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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