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 />
C9352 Packaged N<br />
C9353 Packaged N<br />
C9354 Packaged N<br />
C9355 Packaged N<br />
C9356 $26.37 N<br />
C9358 $10.64 N<br />
C9359 $61.47 N<br />
C9360 $11.14 N<br />
C9361 $250.53 N<br />
C9362 $63.60 N<br />
C9363 $28.30 N<br />
C9364 $18.09 N<br />
C9399 Packaged N<br />
C9716 $2,021.94 N<br />
C9724 $1,524.90 Y<br />
C9725 $337.08 N<br />
C9726 $1,555.14 N<br />
C9727 $478.74 N<br />
C9728 $864.39 N<br />
C9898 Packaged N<br />
D0150 $648.57 N<br />
D0240 $648.57 N<br />
D0250 $648.57 N<br />
D0260 $648.57 N<br />
D0270 $648.57 N<br />
D0272 $648.57 N<br />
D0274 $648.57 N<br />
D0277 $648.57 N<br />
D0417 By Report N<br />
D0418 By Report N<br />
D0460 $648.57 N<br />
D1510 $648.57 N<br />
D1515 $648.57 N<br />
D1520 $648.57 N<br />
D1525 $648.57 N<br />
D1550 $648.57 N<br />
D2999 $648.57 N<br />
D3222 By Report N<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
D3460 $648.57 N<br />
D3999 $648.57 N<br />
D4260 $648.57 N<br />
D4263 $648.57 N<br />
D4264 $648.57 N<br />
D4268 $648.57 N<br />
D4270 $648.57 N<br />
D4271 $648.57 N<br />
D4273 $648.57 N<br />
D4355 $648.57 N<br />
D4381 $648.57 N<br />
D5911 $648.57 N<br />
D5912 $648.57 N<br />
D5983 $648.57 N<br />
D5984 $648.57 N<br />
D5985 $648.57 N<br />
D5987 $648.57 N<br />
D5991 By Report N<br />
D6920 $648.57 N<br />
D7111 $648.57 N<br />
D7140 $648.57 N<br />
D7210 $648.57 N<br />
D7220 $648.57 N<br />
D7230 $648.57 N<br />
D7240 $648.57 N<br />
D7241 $648.57 N<br />
D7250 $648.57 N<br />
D7260 $648.57 N<br />
D7261 $648.57 N<br />
D7291 $648.57 N<br />
D7940 $648.57 N<br />
D9110 Packaged N<br />
D9230 Packaged N<br />
D9248 Packaged N<br />
D9630 $648.57 N<br />
D9930 $648.57 N<br />
D9940 $648.57 N<br />
D9950 $648.57 N<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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