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 />
58573 $2,942.95 Y<br />
58578 $2,390.93 Y<br />
58579 $1,419.49 Y<br />
58600 $2,215.79 Y<br />
58615 $1,259.44 Y<br />
58660 $2,942.95 Y<br />
58661 $2,942.95 Y<br />
58662 $2,942.95 Y<br />
58670 $2,942.95 Y<br />
58671 $2,942.95 Y<br />
58672 $2,942.95 Y<br />
58673 $2,942.95 Y<br />
58679 $2,390.93 Y<br />
58770 $2,215.79 Y<br />
58800 $1,259.44 Y<br />
58805 $2,215.79 Y<br />
58820 $2,215.79 Y<br />
58823 $1,259.44 Y<br />
58900 $1,259.44 Y<br />
58920 $2,215.79 Y<br />
58925 $2,215.79 Y<br />
58999 $8.29 Y<br />
59000 $214.16 Y<br />
59001 $426.92 Y<br />
59012 $214.16 Y<br />
59015 $214.16 Y<br />
59020 $95.99 Y<br />
59025 $95.99 Y<br />
59030 $214.16 Y<br />
59070 $95.99 Y<br />
59072 $214.16 Y<br />
59074 $214.16 Y<br />
59076 $214.16 Y<br />
59100 $2,215.79 Y<br />
59150 $2,942.95 Y<br />
59151 $2,942.95 Y<br />
59160 $1,259.44 Y<br />
59200 $95.99 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
59300 $1,259.44 Y<br />
59320 $1,259.44 Y<br />
59409 $1,259.44 Y<br />
59412 $1,259.44 Y<br />
59414 $1,259.44 Y<br />
59612 $1,259.44 Y<br />
59812 $1,259.44 Y<br />
59820 $1,259.44 Y<br />
59821 $1,259.44 Y<br />
59840 $1,259.44 Y<br />
59841 $1,259.44 Y<br />
59866 $214.16 Y<br />
59870 $1,259.44 Y<br />
59871 $1,259.44 Y<br />
59897 $8.29 Y<br />
59898 $2,390.93 Y<br />
59899 $8.29 Y<br />
60000 $478.74 Y<br />
60100 $288.96 Y<br />
60200 $3,063.34 Y<br />
60210 $3,063.34 Y<br />
60212 $3,063.34 Y<br />
60220 $3,063.34 Y<br />
60225 $3,063.34 Y<br />
60240 $3,063.34 Y<br />
60252 $2,700.59 Y<br />
60260 $2,700.59 Y<br />
60271 $2,700.59 Y<br />
60280 $3,063.34 Y<br />
60281 $3,063.34 Y<br />
60300 $288.96 Y<br />
60500 $2,700.59 Y<br />
60502 $2,700.59 Y<br />
60512 $1,469.46 Y<br />
60520 $2,700.59 Y<br />
60659 $2,390.93 Y<br />
60699 $3,063.34 Y<br />
61000 $452.39 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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