How big an issue to repair Code P0046 on 2006 F250 super duty 6.0 turbo diesel?

Hello, any issues with the 6.0L Ford Power Stroke Diesel engine should be addresed by a trained expert. These are complicated vehicles to diagnose and repair -- but -- Ford trained and experienced technicians can be outstanding working on them. These vehicles have multiple concerns related to the variable geometry turbocharger and related components. You can't guess here. And even if you need to replace the turbocharger if it is diagnosed as failed or internally binding due to debris, other steps may be needed to prevent further issues or immediate occurrence once repaired. I cannot stress enough the need to consult a professional on this.