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 />
86079 $15.59 N<br />
86485 $5.02 N<br />
86486 $5.02 N<br />
86490 $5.02 N<br />
86510 $5.02 N<br />
86580 $5.02 N<br />
86780 $25.89 N<br />
86825 $106.14 N<br />
86826 $35.38 N<br />
86850 $13.79 N<br />
86860 $23.46 N<br />
86870 $23.46 N<br />
86880 $7.29 N<br />
86885 $7.29 N<br />
86886 $7.29 N<br />
86890 $46.39 N<br />
86891 $13.79 N<br />
86900 $7.29 N<br />
86901 $7.29 N<br />
86903 $13.79 N<br />
86904 $13.79 N<br />
86905 $13.79 N<br />
86906 $13.79 N<br />
86920 $13.79 N<br />
86921 $13.79 N<br />
86922 $23.46 N<br />
86923 $13.79 N<br />
86927 $13.79 N<br />
86930 $46.39 N<br />
86931 $46.39 N<br />
86932 $46.39 N<br />
86945 $13.79 N<br />
86950 $13.79 N<br />
86960 $13.79 N<br />
86965 $23.46 N<br />
86970 $13.79 N<br />
86971 $13.79 N<br />
86972 $13.79 N<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
86975 $23.46 N<br />
86976 $13.79 N<br />
86977 $46.39 N<br />
86978 $23.46 N<br />
86985 $13.79 N<br />
86999 $13.79 N<br />
87150 $68.62 N<br />
87153 $225.53 N<br />
87493 $68.62 N<br />
87500 $69.96 N<br />
87809 $23.91 N<br />
87905 $24.35 N<br />
88104 $15.59 N<br />
88106 $15.59 N<br />
88107 $33.31 N<br />
88108 $15.59 N<br />
88112 $33.31 N<br />
88125 $15.59 N<br />
88141 Packaged N<br />
88160 $15.59 N<br />
88161 $15.59 N<br />
88162 $33.31 N<br />
88172 $33.31 N<br />
88173 $33.31 N<br />
88182 $33.31 N<br />
88184 $15.59 N<br />
88185 $15.59 N<br />
88187 $9.71 N<br />
88188 $33.31 N<br />
88189 $33.31 N<br />
88199 $9.71 N<br />
88299 $9.71 N<br />
88300 $15.59 N<br />
88302 $15.59 N<br />
88304 $33.31 N<br />
88305 $33.31 N<br />
88307 $50.44 N<br />
88309 $50.44 N<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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