Ambulatory Surgery Center Fee Schedule - Washington Department ...
Ambulatory Surgery Center Fee Schedule - Washington Department ...
Ambulatory Surgery Center Fee Schedule - Washington Department ...
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
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 />
J8521 $20.04 N<br />
J8530 Packaged N<br />
J8540 Packaged N<br />
J8560 $29.69 N<br />
J8597 Packaged N<br />
J8600 Packaged N<br />
J8610 Packaged N<br />
J8700 $8.63 N<br />
J8705 $73.00 N<br />
J9000 Packaged N<br />
J9001 $462.49 N<br />
J9010 $555.50 N<br />
J9015 $830.93 N<br />
J9017 $36.83 N<br />
J9020 $59.27 N<br />
J9025 $4.79 N<br />
J9027 $113.36 N<br />
J9031 $108.55 N<br />
J9033 $18.51 N<br />
J9035 $56.37 N<br />
J9040 Packaged N<br />
J9041 $37.52 N<br />
J9045 Packaged N<br />
J9050 $173.53 N<br />
J9055 $48.79 N<br />
J9060 Packaged N<br />
J9062 Packaged N<br />
J9065 $23.52 N<br />
J9070 Bundled N<br />
J9080 Bundled N<br />
J9090 Bundled N<br />
J9091 Bundled N<br />
J9092 Bundled N<br />
J9093 Bundled N<br />
J9094 Bundled N<br />
J9095 Packaged N<br />
J9096 Packaged N<br />
J9097 Packaged N<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
J9098 $480.16 N<br />
J9100 Packaged N<br />
J9110 Packaged N<br />
J9120 $556.34 N<br />
J9130 Packaged N<br />
J9140 Packaged N<br />
J9150 $16.65 N<br />
J9151 $55.33 N<br />
J9155 $2.87 N<br />
J9160 $1,467.55 N<br />
J9165 $3.83 N<br />
J9171 $17.29 N<br />
J9175 Packaged N<br />
J9178 $2.60 N<br />
J9181 Packaged N<br />
J9185 $158.63 N<br />
J9190 Packaged N<br />
J9200 $42.85 N<br />
J9201 $142.20 N<br />
J9202 $200.02 N<br />
J9206 $6.81 N<br />
J9207 $63.74 N<br />
J9208 $29.51 N<br />
J9209 $4.55 N<br />
J9211 $100.89 N<br />
J9212 $4.71 N<br />
J9213 $10.60 N<br />
J9214 $15.54 N<br />
J9215 $17.89 N<br />
J9216 $294.03 N<br />
J9217 $202.62 N<br />
J9218 $4.68 N<br />
J9219 $4,728.88 N<br />
J9225 $1,462.69 N<br />
J9226 $14,841.08 N<br />
J9230 $151.24 N<br />
J9245 $1,520.24 N<br />
J9250 Packaged N<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
Page | 89