Ambulatory Surgery Center Fee Schedule - Washington Department ...

More documents

Recommendations

Info

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 91133 $95.52 N 91299 $95.52 N 92018 $976.42 Y 92019 $976.42 Y 92020 $37.35 N 92025 $60.02 N 92060 $60.02 N 92070 Packaged N 92081 $37.35 N 92082 $60.02 N 92083 $60.02 N 92100 Packaged N 92120 $60.02 N 92130 $37.35 N 92135 $37.35 N 92136 $60.02 N 92140 $37.35 N 92225 $37.35 N 92226 $60.02 N 92230 $122.99 N 92235 $122.99 N 92240 $122.99 N 92250 $60.02 N 92260 $37.35 N 92265 $60.02 N 92270 $37.35 N 92275 $122.99 N 92283 $37.35 N 92284 $60.02 N 92285 $60.02 N 92286 $122.99 N 92287 $122.99 N 92311 $60.02 N 92312 $60.02 N 92313 $37.35 N 92315 $37.35 N 92316 $60.02 N 92317 $37.35 N Procedure Code Allowed Amount Multiple Procedure Discounting 92325 $37.35 N 92326 $60.02 N 92352 $60.02 N 92353 $37.35 N 92354 $37.35 N 92355 $37.35 N 92358 $37.35 N 92371 $37.35 N 92499 $37.35 N 92502 $215.19 Y 92504 Packaged N 92511 $50.31 Y 92516 $94.36 N 92520 $94.36 N 92531 Packaged N 92532 Packaged N 92533 Packaged N 92534 Packaged N 92540 $94.36 N 92541 $56.93 N 92542 $56.93 N 92543 $94.36 N 92544 $56.93 N 92545 $56.93 N 92546 $94.36 N 92547 Packaged N 92548 $94.36 N 92550 $29.53 N 92552 $29.53 N 92553 $79.64 N 92555 $29.53 N 92556 $29.53 N 92557 $79.64 N 92561 $29.53 N 92562 $29.53 N 92563 $29.53 N 92564 $29.53 N 92565 $29.53 N CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply Page | 70
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 92567 $29.53 N 92568 $29.53 N 92570 $29.53 N 92571 $29.53 N 92572 $102.05 N 92575 $29.53 N 92576 $29.53 N 92577 $102.05 N 92579 $79.64 N 92582 $79.64 N 92583 $29.53 N 92584 $168.58 N 92585 $168.58 N 92586 $75.18 N 92587 $56.93 N 92588 $56.93 N 92596 $29.53 N 92601 $102.05 N 92602 $102.05 N 92603 $102.05 N 92604 $102.05 N 92620 $79.64 N 92621 Packaged N 92625 $79.64 N 92626 $102.05 N 92627 Packaged N 92640 $79.64 N 92700 $29.53 N 92950 $154.27 N 92953 $154.27 N 92960 $345.86 N 92961 $345.86 N 92973 $2,569.76 Y 92974 $1,121.11 Y 92977 $150.50 Y 92978 Packaged N 92979 Packaged N 92980 $5,326.54 Y Procedure Code Allowed Amount Multiple Procedure Discounting 92981 $5,326.54 Y 92982 $3,184.27 Y 92984 $3,184.27 Y 92986 $3,184.27 Y 92987 $3,184.27 Y 92990 $3,184.27 Y 92995 $5,863.55 Y 92996 $5,863.55 Y 92997 $3,184.27 Y 92998 $3,184.27 Y 93005 $24.75 N 93012 Packaged N 93017 $164.21 N 93024 $164.21 N 93025 $164.21 N 93041 $14.58 N 93225 $61.87 N 93226 $61.87 N 93228 $39.05 N 93229 $718.24 N 93231 $61.87 N 93232 $61.87 N 93236 $61.87 N 93270 $61.87 N 93271 $100.53 N 93278 $14.58 N 93279 $22.03 N 93280 $22.03 N 93281 $22.03 N 93282 $35.69 N 93283 $35.69 N 93284 $35.69 N 93285 $22.03 N 93286 $35.69 N 93287 $35.69 N 93288 $22.03 N 93289 $35.69 N 93290 $22.03 N CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply Page | 71
Page 1 and 2:
Ambulatory Surgery Center Fee Sched
Page 3 and 4:
DOC ASC Fee Schedule Effective Date
Page 5 and 6:
Pain Management Procedures DOC ASC
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20: DOC ASC Fee Schedule Effective Date
Page 69: DOC ASC Fee Schedule Effective Date
show all

Ambulatory Surgery Center Fee Schedule - Washington Department ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?