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 />
35190 $2,236.55 Y<br />
35201 $2,236.55 Y<br />
35206 $2,236.55 Y<br />
35207 $2,569.76 Y<br />
35226 $515.38 Y<br />
35231 $2,236.55 Y<br />
35236 $2,236.55 Y<br />
35256 $2,236.55 Y<br />
35261 $2,933.42 Y<br />
35266 $2,933.42 Y<br />
35286 $2,933.42 Y<br />
35321 $2,236.55 Y<br />
35458 $3,184.27 Y<br />
35459 $3,184.27 Y<br />
35460 $3,184.27 Y<br />
35470 $3,184.27 Y<br />
35471 $3,184.27 Y<br />
35472 $3,184.27 Y<br />
35473 $3,184.27 Y<br />
35474 $3,184.27 Y<br />
35475 $3,184.27 Y<br />
35476 $3,184.27 Y<br />
35484 $5,863.55 Y<br />
35485 $5,863.55 Y<br />
35490 $5,863.55 Y<br />
35491 $5,863.55 Y<br />
35492 $5,863.55 Y<br />
35493 $5,863.55 Y<br />
35494 $5,863.55 Y<br />
35495 $5,863.55 Y<br />
35500 $1,121.11 Y<br />
35523 $1,926.10 Y<br />
35535 $3,050.85 Y<br />
35570 $2,357.85 Y<br />
35572 Packaged N<br />
35632 $2,896.85 Y<br />
35633 $3,127.85 Y<br />
35634 $2,835.25 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
35685 $2,236.55 Y<br />
35686 $2,236.55 Y<br />
35761 $2,236.55 Y<br />
35860 $2,236.55 Y<br />
35875 $2,569.76 Y<br />
35876 $2,569.76 Y<br />
35879 $2,569.76 Y<br />
35881 $2,569.76 Y<br />
35883 $2,569.76 Y<br />
35884 $2,569.76 Y<br />
35903 $2,236.55 Y<br />
36000 Packaged N<br />
36002 $144.54 N<br />
36005 Packaged N<br />
36010 Packaged N<br />
36011 Packaged N<br />
36012 Packaged N<br />
36013 Packaged N<br />
36014 Packaged N<br />
36015 Packaged N<br />
36100 Packaged N<br />
36120 Packaged N<br />
36140 Packaged N<br />
36147 $150.50 Y<br />
36148 Packaged N<br />
36160 Packaged N<br />
36200 Packaged N<br />
36215 Packaged N<br />
36216 Packaged N<br />
36217 Packaged N<br />
36218 Packaged N<br />
36245 Packaged N<br />
36246 Packaged N<br />
36247 Packaged N<br />
36248 Packaged N<br />
36260 $1,912.51 Y<br />
36261 $1,441.39 Y<br />
36262 $1,441.39 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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