Ambulatory Surgery Center Fee Schedule - Washington Department ...

DOC ASC Fee Schedule
Effective Dates of Service 7/1/2012 thru 8/31/2012
Refer to the 2012 CPT® and HCPCS coding books for complete code descriptions
Procedure
Code
Allowed
Amount
Multiple
Procedure
Discounting
27257 $960.81 Y
27265 $104.15 Y
27266 $960.81 Y
27267 $104.15 Y
27268 $704.00 Y
27269 $1,695.65 Y
27275 $960.81 Y
27299 $104.15 Y
27301 $1,219.29 Y
27305 $1,383.19 Y
27306 $1,383.19 Y
27307 $1,383.19 Y
27310 $1,996.21 Y
27323 $515.38 Y
27324 $1,469.46 Y
27325 $1,176.17 Y
27326 $1,176.17 Y
27327 $1,469.46 Y
27328 $1,099.36 Y
27329 $1,099.36 Y
27330 $1,996.21 Y
27331 $1,996.21 Y
27332 $1,996.21 Y
27333 $1,996.21 Y
27334 $1,996.21 Y
27335 $1,996.21 Y
27337 $1,469.46 Y
27339 $1,469.46 Y
27340 $1,383.19 Y
27345 $1,383.19 Y
27347 $1,383.19 Y
27350 $1,996.21 Y
27355 $1,996.21 Y
27356 $1,996.21 Y
27357 $1,996.21 Y
27358 $1,996.21 Y
27360 $1,996.21 Y
27364 $1,469.46 Y
Procedure
Code
Allowed
Amount
Multiple
Procedure
Discounting
27370 Packaged N
27372 $1,469.46 Y
27380 $1,383.19 Y
27381 $1,383.19 Y
27385 $1,383.19 Y
27386 $1,383.19 Y
27390 $1,383.19 Y
27391 $1,383.19 Y
27392 $1,383.19 Y
27393 $1,996.21 Y
27394 $1,996.21 Y
27395 $2,926.52 Y
27396 $1,996.21 Y
27397 $2,926.52 Y
27400 $2,926.52 Y
27403 $1,996.21 Y
27405 $2,926.52 Y
27407 $5,569.99 Y
27409 $2,926.52 Y
27412 $5,569.99 Y
27415 $5,569.99 Y
27416 $2,926.52 Y
27418 $2,926.52 Y
27420 $2,926.52 Y
27422 $2,926.52 Y
27424 $2,926.52 Y
27425 $1,996.21 Y
27427 $2,926.52 Y
27428 $5,569.99 Y
27429 $5,569.99 Y
27430 $2,926.52 Y
27435 $2,926.52 Y
27437 $2,506.14 Y
27438 $3,649.39 Y
27440 $2,506.14 Y
27441 $2,506.14 Y
27442 $2,506.14 Y
27443 $2,506.14 Y
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply
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