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 />
27695 $1,996.21 Y<br />
27696 $1,996.21 Y<br />
27698 $1,996.21 Y<br />
27700 $2,506.14 Y<br />
27704 $1,383.19 Y<br />
27705 $2,926.52 Y<br />
27707 $1,383.19 Y<br />
27709 $1,996.21 Y<br />
27720 $2,856.73 Y<br />
27722 $4,113.79 Y<br />
27726 $2,856.73 Y<br />
27730 $1,996.21 Y<br />
27732 $1,996.21 Y<br />
27734 $1,996.21 Y<br />
27740 $1,996.21 Y<br />
27742 $2,926.52 Y<br />
27745 $5,569.99 Y<br />
27750 $104.15 Y<br />
27752 $1,155.83 Y<br />
27756 $1,623.81 Y<br />
27758 $2,856.73 Y<br />
27759 $4,113.79 Y<br />
27760 $104.15 Y<br />
27762 $1,155.83 Y<br />
27766 $2,856.73 Y<br />
27767 $104.15 Y<br />
27768 $104.15 Y<br />
27769 $2,856.73 Y<br />
27780 $104.15 Y<br />
27781 $1,155.83 Y<br />
27784 $2,856.73 Y<br />
27786 $104.15 Y<br />
27788 $104.15 Y<br />
27792 $2,856.73 Y<br />
27808 $104.15 Y<br />
27810 $301.24 Y<br />
27814 $2,856.73 Y<br />
27816 $104.15 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
27818 $301.24 Y<br />
27822 $2,856.73 Y<br />
27823 $4,113.79 Y<br />
27824 $104.15 Y<br />
27825 $1,155.83 Y<br />
27826 $2,856.73 Y<br />
27827 $4,113.79 Y<br />
27828 $4,113.79 Y<br />
27829 $2,856.73 Y<br />
27830 $104.15 Y<br />
27831 $1,155.83 Y<br />
27832 $2,856.73 Y<br />
27840 $301.24 Y<br />
27842 $960.81 Y<br />
27846 $2,856.73 Y<br />
27848 $2,856.73 Y<br />
27860 $960.81 Y<br />
27870 $5,569.99 Y<br />
27871 $5,569.99 Y<br />
27884 $1,383.19 Y<br />
27889 $1,996.21 Y<br />
27892 $1,996.21 Y<br />
27893 $1,996.21 Y<br />
27894 $1,996.21 Y<br />
27899 $104.15 Y<br />
28001 $793.02 Y<br />
28002 $1,383.19 Y<br />
28003 $1,383.19 Y<br />
28005 $1,372.45 Y<br />
28008 $1,372.45 Y<br />
28010 $1,372.45 Y<br />
28011 $1,372.45 Y<br />
28020 $1,372.45 Y<br />
28022 $1,372.45 Y<br />
28024 $1,372.45 Y<br />
28035 $1,176.17 Y<br />
28039 $1,469.46 Y<br />
28041 $1,469.46 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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