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 />
29827 $3,067.20 Y<br />
29828 $3,067.20 Y<br />
29830 $1,879.86 Y<br />
29834 $1,879.86 Y<br />
29835 $1,879.86 Y<br />
29836 $1,879.86 Y<br />
29837 $1,879.86 Y<br />
29838 $1,879.86 Y<br />
29840 $1,879.86 Y<br />
29843 $1,879.86 Y<br />
29844 $1,879.86 Y<br />
29845 $1,879.86 Y<br />
29846 $1,879.86 Y<br />
29847 $3,067.20 Y<br />
29848 $1,879.86 Y<br />
29850 $1,879.86 Y<br />
29851 $3,067.20 Y<br />
29855 $3,067.20 Y<br />
29856 $3,067.20 Y<br />
29860 $3,067.20 Y<br />
29861 $3,067.20 Y<br />
29862 $3,067.20 Y<br />
29863 $3,067.20 Y<br />
29870 $1,879.86 Y<br />
29871 $1,879.86 Y<br />
29873 $1,879.86 Y<br />
29874 $1,879.86 Y<br />
29875 $1,879.86 Y<br />
29876 $1,879.86 Y<br />
29877 $1,879.86 Y<br />
29879 $1,879.86 Y<br />
29880 $1,879.86 Y<br />
29881 $1,879.86 Y<br />
29882 $1,879.86 Y<br />
29883 $1,879.86 Y<br />
29884 $1,879.86 Y<br />
29885 $3,067.20 Y<br />
29886 $1,879.86 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
29887 $1,879.86 Y<br />
29888 $5,569.99 Y<br />
29889 $5,569.99 Y<br />
29891 $3,067.20 Y<br />
29892 $5,569.99 Y<br />
29893 $1,372.45 Y<br />
29894 $1,879.86 Y<br />
29895 $1,879.86 Y<br />
29897 $1,879.86 Y<br />
29898 $1,879.86 Y<br />
29899 $3,067.20 Y<br />
29900 $1,879.86 Y<br />
29901 $1,879.86 Y<br />
29902 $1,879.86 Y<br />
29904 $1,879.86 Y<br />
29905 $1,879.86 Y<br />
29906 $1,879.86 Y<br />
29907 $3,067.20 Y<br />
29999 $1,879.86 Y<br />
30000 $215.19 Y<br />
30020 $215.19 Y<br />
30100 $478.74 Y<br />
30110 $1,079.91 Y<br />
30115 $1,079.91 Y<br />
30117 $1,079.91 Y<br />
30118 $1,568.46 Y<br />
30120 $1,568.46 Y<br />
30124 $478.74 Y<br />
30125 $2,700.59 Y<br />
30130 $1,079.91 Y<br />
30140 $1,568.46 Y<br />
30150 $2,700.59 Y<br />
30160 $2,700.59 Y<br />
30200 $478.74 Y<br />
30210 $478.74 Y<br />
30220 $478.74 Y<br />
30300 $42.05 N<br />
30310 $1,079.91 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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