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
46280 $1,506.05 Y
46285 $1,506.05 Y
46288 $1,506.05 Y
46320 $1,506.05 Y
46500 $886.78 Y
46505 $1,506.05 Y
46600 $42.05 N
46604 $580.86 Y
46606 $362.82 Y
46608 $580.86 Y
46610 $1,433.83 Y
46611 $580.86 Y
46612 $1,433.83 Y
46614 $362.82 Y
46615 $1,433.83 Y
46700 $1,506.05 Y
46706 $2,021.94 Y
46707 By Report N
46750 $2,021.94 Y
46753 $1,506.05 Y
46754 $1,506.05 Y
46760 $2,021.94 Y
46761 $2,021.94 Y
46762 $2,021.94 Y
46900 $175.81 Y
46910 $1,336.09 Y
46916 $96.83 Y
46917 $1,336.09 Y
46922 $1,336.09 Y
46924 $1,336.09 Y
46930 $517.54 Y
46940 $1,506.05 Y
46942 $337.08 Y
46945 $886.78 Y
46946 $886.78 Y
46947 $2,021.94 Y
46999 $337.08 Y
47000 $607.35 Y
Procedure
Code
Allowed
Amount
Multiple
Procedure
Discounting
47001 Packaged N
47011 $973.88 Y
47370 $6,906.48 Y
47371 $6,906.48 Y
47379 $2,390.93 Y
47382 $3,227.05 Y
47399 $288.96 Y
47490 $1,931.58 Y
47500 Packaged N
47505 Packaged N
47510 $1,931.58 Y
47511 $1,931.58 Y
47525 $961.94 Y
47530 $961.94 Y
47552 $1,931.58 Y
47553 $1,931.58 Y
47554 $1,931.58 Y
47555 $1,931.58 Y
47556 $1,931.58 Y
47560 $2,390.93 Y
47561 $2,390.93 Y
47562 $2,942.95 Y
47563 $2,942.95 Y
47564 $2,942.95 Y
47579 $2,390.93 Y
47630 $1,931.58 Y
47999 $1,931.58 Y
48102 $607.35 Y
48511 $973.88 Y
48999 $288.96 Y
49021 $973.88 Y
49041 $973.88 Y
49061 $973.88 Y
49080 $348.84 Y
49081 $348.84 Y
49180 $607.35 Y
49203 $1,636.25 Y
49204 $2,088.90 Y
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply
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