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 />
J9260 Packaged N<br />
J9261 $101.35 N<br />
J9263 $7.47 N<br />
J9264 $9.20 N<br />
J9265 Packaged N<br />
J9266 $2,695.46 N<br />
J9268 $1,318.44 N<br />
J9270 Packaged N<br />
J9280 $16.83 N<br />
J9290 $67.30 N<br />
J9291 $134.60 N<br />
J9293 $46.87 N<br />
J9300 $2,573.49 N<br />
J9303 $85.35 N<br />
J9305 $49.63 N<br />
J9310 $553.12 N<br />
J9320 $278.77 N<br />
J9328 $4.90 N<br />
J9330 $48.90 N<br />
J9340 $103.08 N<br />
J9350 $1,012.44 N<br />
J9355 $63.56 N<br />
J9357 $933.57 N<br />
J9360 Packaged N<br />
J9370 Packaged N<br />
J9375 Packaged N<br />
J9380 Packaged N<br />
J9390 Packaged N<br />
J9395 $80.66 N<br />
J9600 $2,748.96 N<br />
J9999 Packaged N<br />
L8600 Packaged N<br />
L8603 Packaged N<br />
L8604 Packaged N<br />
L8606 Packaged N<br />
L8609 Packaged N<br />
L8610 Packaged N<br />
L8612 Packaged N<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
L8613 Packaged N<br />
L8614 Packaged N<br />
L8627 By Report N<br />
L8628 By Report N<br />
L8629 By Report N<br />
L8630 Packaged N<br />
L8631 Packaged N<br />
L8641 Packaged N<br />
L8642 Packaged N<br />
L8658 Packaged N<br />
L8659 Packaged N<br />
L8670 Packaged N<br />
L8682 Packaged N<br />
L8690 By Report N<br />
L8692 By Report N<br />
L8699 Packaged N<br />
L9900 Packaged N<br />
P9010 $192.25 N<br />
P9011 $81.46 N<br />
P9012 $43.42 N<br />
P9016 $174.06 N<br />
P9017 $70.86 N<br />
P9019 $62.09 N<br />
P9020 $127.51 N<br />
P9021 $132.11 N<br />
P9022 $229.30 N<br />
P9023 $47.68 N<br />
P9031 $97.64 N<br />
P9032 $140.24 N<br />
P9033 $123.00 N<br />
P9034 $437.26 N<br />
P9035 $477.34 N<br />
P9036 $333.66 N<br />
P9037 $630.64 N<br />
P9038 $210.47 N<br />
P9039 $339.21 N<br />
P9040 $228.39 N<br />
P9041 $16.89 N<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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