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 />
64585 $1,894.41 Y<br />
64590 $19,881.73 N<br />
64595 $2,765.06 Y<br />
64600 $1,277.58 Y<br />
64605 $1,805.84 Y<br />
64610 $1,805.84 Y<br />
64612 $246.55 Y<br />
64613 $359.06 Y<br />
64614 $359.06 Y<br />
64620 $694.57 Y<br />
64622 $1,277.58 Y<br />
64623 $694.57 Y<br />
64626 $694.57 Y<br />
64627 $246.55 Y<br />
64630 $694.57 Y<br />
64632 $246.55 Y<br />
64640 $694.57 Y<br />
64680 $694.57 Y<br />
64681 $1,277.58 Y<br />
64702 $1,176.17 Y<br />
64704 $1,176.17 Y<br />
64708 $1,176.17 Y<br />
64712 $1,176.17 Y<br />
64713 $1,176.17 Y<br />
64714 $1,176.17 Y<br />
64716 $1,176.17 Y<br />
64718 $1,176.17 Y<br />
64719 $1,176.17 Y<br />
64721 $1,176.17 Y<br />
64722 $1,176.17 Y<br />
64726 $1,176.17 Y<br />
64727 $1,176.17 Y<br />
64732 $1,176.17 Y<br />
64734 $1,176.17 Y<br />
64736 $1,176.17 Y<br />
64738 $1,176.17 Y<br />
64740 $1,176.17 Y<br />
64742 $1,176.17 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
64744 $1,176.17 Y<br />
64746 $1,176.17 Y<br />
64761 $1,176.17 Y<br />
64763 $1,176.17 Y<br />
64766 $2,342.33 Y<br />
64771 $1,176.17 Y<br />
64772 $1,176.17 Y<br />
64774 $1,176.17 Y<br />
64776 $1,176.17 Y<br />
64778 $1,176.17 Y<br />
64782 $1,176.17 Y<br />
64783 $1,176.17 Y<br />
64784 $1,176.17 Y<br />
64786 $2,342.33 Y<br />
64787 $1,176.17 Y<br />
64788 $1,176.17 Y<br />
64790 $1,176.17 Y<br />
64792 $2,342.33 Y<br />
64795 $1,176.17 Y<br />
64802 $1,176.17 Y<br />
64804 $1,176.17 Y<br />
64820 $1,176.17 Y<br />
64821 $1,774.16 Y<br />
64822 $1,774.16 Y<br />
64823 $1,774.16 Y<br />
64831 $2,342.33 Y<br />
64832 $2,342.33 Y<br />
64834 $2,342.33 Y<br />
64835 $2,342.33 Y<br />
64836 $2,342.33 Y<br />
64837 $2,342.33 Y<br />
64840 $2,342.33 Y<br />
64856 $2,342.33 Y<br />
64857 $2,342.33 Y<br />
64858 $2,342.33 Y<br />
64859 $2,342.33 Y<br />
64861 $2,342.33 Y<br />
64862 $2,342.33 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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