Ambulatory Surgery Center Fee Schedule - Washington Department ...
Ambulatory Surgery Center Fee Schedule - Washington Department ...
Ambulatory Surgery Center Fee Schedule - Washington Department ...
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DOC ASC <strong>Fee</strong> <strong>Schedule</strong><br />
Effective Dates of Service 7/1/2012 thru 8/31/2012<br />
Refer to the 2012 CPT® and HCPCS coding books for complete code descriptions<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
26450 $1,070.75 Y<br />
26455 $1,070.75 Y<br />
26460 $1,070.75 Y<br />
26471 $1,070.75 Y<br />
26474 $1,070.75 Y<br />
26476 $1,070.75 Y<br />
26477 $1,070.75 Y<br />
26478 $1,070.75 Y<br />
26479 $1,070.75 Y<br />
26480 $1,774.16 Y<br />
26483 $1,774.16 Y<br />
26485 $1,774.16 Y<br />
26489 $1,774.16 Y<br />
26490 $1,774.16 Y<br />
26492 $1,774.16 Y<br />
26494 $1,774.16 Y<br />
26496 $1,774.16 Y<br />
26497 $1,774.16 Y<br />
26498 $1,774.16 Y<br />
26499 $1,774.16 Y<br />
26500 $1,070.75 Y<br />
26502 $1,774.16 Y<br />
26508 $1,070.75 Y<br />
26510 $1,774.16 Y<br />
26516 $1,774.16 Y<br />
26517 $1,774.16 Y<br />
26518 $1,774.16 Y<br />
26520 $1,070.75 Y<br />
26525 $1,070.75 Y<br />
26530 $2,506.14 Y<br />
26531 $3,649.39 Y<br />
26535 $2,506.14 Y<br />
26536 $3,649.39 Y<br />
26540 $1,070.75 Y<br />
26541 $1,774.16 Y<br />
26542 $1,070.75 Y<br />
26545 $1,774.16 Y<br />
26546 $1,774.16 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
26548 $1,774.16 Y<br />
26550 $1,774.16 Y<br />
26555 $1,774.16 Y<br />
26560 $1,070.75 Y<br />
26561 $1,774.16 Y<br />
26562 $1,774.16 Y<br />
26565 $1,774.16 Y<br />
26567 $1,774.16 Y<br />
26568 $1,774.16 Y<br />
26580 $1,070.75 Y<br />
26587 $1,070.75 Y<br />
26590 $1,070.75 Y<br />
26591 $1,774.16 Y<br />
26593 $1,070.75 Y<br />
26596 $1,070.75 Y<br />
26600 $104.15 Y<br />
26605 $104.15 Y<br />
26607 $1,155.83 Y<br />
26608 $1,623.81 Y<br />
26615 $2,856.73 Y<br />
26641 $104.15 Y<br />
26645 $301.24 Y<br />
26650 $1,623.81 Y<br />
26665 $2,856.73 Y<br />
26670 $104.15 Y<br />
26675 $301.24 Y<br />
26676 $1,623.81 Y<br />
26685 $1,623.81 Y<br />
26686 $4,113.79 Y<br />
26700 $104.15 Y<br />
26705 $104.15 Y<br />
26706 $1,155.83 Y<br />
26715 $1,623.81 Y<br />
26720 $104.15 Y<br />
26725 $104.15 Y<br />
26727 $1,623.81 Y<br />
26735 $1,623.81 Y<br />
26740 $104.15 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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