Transcription
2020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE0010000102ANESTH SALIVARY GLAND1994121322991231ANESTH REPAIR OF CLEFT LIP199412132299123100103ANESTH BLEPHAROPLASTY199412132299123100104ANESTH ELECTROSHOCK199412132299123100120ANESTH EAR SURGERY199412132299123100124ANESTH EAR EXAM199412132299123100126ANESTH TYMPANOTOMY199412132299123100140ANESTH PROCEDURES ON EYE199412132299123100142ANESTH LENS SURGERY199412132299123100144ANESTH CORNEAL TRANSPLANT199412132299123100145ANESTH VITREORETINAL SURG199412132299123100147ANESTH IRIDECTOMY199412132299123100148ANESTH EYE EXAM199412132299123100160ANESTH NOSE/SINUS SURGERY199412132299123100162ANESTH NOSE/SINUS SURGERY199412132299123100164ANESTH BIOPSY OF NOSE199412132299123100170ANESTH PROCEDURE ON MOUTH19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESGROUPERAMT PRICE ASC
Attached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00172ANESTH CLEFT PALATE REPAIR199412132299123100174ANESTH PHARYNGEAL SURGERY199412132299123100176ANESTH PHARYNGEAL SURGERY199412132299123100190ANESTH FACE/SKULL BONE SURG199412132299123100192ANESTH FACIAL BONE SURGERY199412132299123100210ANESTH CRANIAL SURG NOS199412132299123100212ANESTH SKULL DRAINAGE199412132299123100214ANESTH SKULL DRAINAGE199412132299123100215ANESTH SKULL REPAIR/FRACT199412132299123100216ANESTH HEAD VESSEL SURGERY199412132299123100218ANESTH SPECIAL HEAD SURGERY199412132299123100220ANESTH INTRCRN NERVE199412132299123100222ANESTH HEAD NERVE SURGERY199412132299123100300ANESTH HEAD/NECK/PTRUNK199412132299123100320ANESTH NECK ORGAN 1YR/ 199412132299123100322ANESTH BIOPSY OF THYROID199412132299123100350ANESTH NECK VESSEL SURGERY19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00352ANESTH NECK VESSEL SURGERY199412132299123100400ANESTH SKIN EXT/PER/ATRUNK199412132299123100402ANESTH SURGERY OF BREAST199412132299123100404ANESTH SURGERY OF BREAST199412132299123100406ANESTH SURGERY OF BREAST199412132299123100410ANESTH CORRECT HEART RHYTHM199412132299123100450ANESTH SURGERY OF SHOULDER199412132299123100454ANESTH COLLAR BONE BIOPSY199412132299123100470ANESTH REMOVAL OF RIB199412132299123100472ANESTH CHEST WALL REPAIR199412132299123100474ANESTH SURGERY OF RIB199412132299123100500ANESTH ESOPHAGEAL SURGERY199412132299123100520ANESTH CHEST PROCEDURE199412132299123100522ANESTH CHEST LINING BIOPSY199412132299123100524ANESTH CHEST DRAINAGE199412132299123100528ANES MEDIASCPY & DX THORSCPY199412132299123100530ANESTH PACEMAKER INSERTION19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00532ANESTH VASCULAR ACCESS199412132299123100534ANESTH CARDIOVERTER/DEFIB199412132299123100540ANESTH CHEST SURGERY199412132299123100542ANESTHESIA REMOVAL PLEURA199412132299123100546ANESTH LUNG CHEST WALL SURG199412132299123100548ANESTH TRACHEA BRONCHI SURG19941213229912310054TBONE SRGRY CMPTR FLUOR IMAGE20090101229912310055T00560BONE SRGRY CMPTR CT/MRI IMAG2009010122991231ANESTH HEART SURG W/O PUMP199412132299123100562ANESTH HRT SURG W/PMP AGE 1 199412132299123100580ANESTH HEART/LUNG TRANSPLNT199412132299123100600ANESTH SPINE CORD SURGERY199412132299123100604ANESTH SITTING PROCEDURE199412132299123100620ANESTH SPINE CORD SURGERY199412132299123100630ANESTH SPINE CORD SURGERY199412132299123100632ANESTH REMOVAL OF NERVES199412132299123100670ANESTH SPINE CORD SURGERY19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00700ANESTH ABDOMINAL WALL SURG199412132299123100702ANESTH FOR LIVER BIOPSY199412132299123100730ANESTH ABDOMINAL WALL SURG199412132299123100731ANES UPR GI NDSC PX NOS201801012299123100732ANES UPR GI NDSC PX ERCP201801012299123100750ANESTH REPAIR OF HERNIA199412132299123100752ANESTH REPAIR OF HERNIA199412132299123100754ANESTH REPAIR OF HERNIA199412132299123100756ANESTH REPAIR OF HERNIA199412132299123100770ANESTH BLOOD VESSEL REPAIR199412132299123100790ANESTH SURG UPPER ABDOMEN199412132299123100792ANESTH HEMORR/EXCISE LIVER199412132299123100794ANESTH PANCREAS REMOVAL199412132299123100796ANESTH FOR LIVER TRANSPLANT199412132299123100800ANESTH ABDOMINAL WALL SURG199412132299123100802ANESTH FAT LAYER REMOVAL199412132299123100811ANES LWR INTST NDSC NOS20180101229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00812ANES LWR INTST SCR COLSC201801012299123100813ANES UPR LWR GI NDSC PX201801012299123100820ANESTH ABDOMINAL WALL SURG199412132299123100830ANESTH REPAIR OF HERNIA199412132299123100832ANESTH REPAIR OF HERNIA199412132299123100840ANESTH SURG LOWER ABDOMEN199412132299123100842ANESTH AMNIOCENTESIS199412132299123100844ANESTH PELVIS SURGERY199412132299123100846ANESTH HYSTERECTOMY199412132299123100848ANESTH PELVIC ORGAN SURG199412132299123100860ANESTH SURGERY OF ABDOMEN199412132299123100862ANESTH KIDNEY/URETER SURG199412132299123100864ANESTH REMOVAL OF BLADDER199412132299123100865ANESTH REMOVAL OF PROSTATE199601012299123100866ANESTH REMOVAL OF ADRENAL199412132299123100868ANESTH KIDNEY TRANSPLANT199412132299123100870ANESTH BLADDER STONE SURG19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00872ANESTH KIDNEY STONE DESTRUCT199412132299123100873ANESTH KIDNEY STONE DESTRUCT199412132299123100880ANESTH ABDOMEN VESSEL SURG199412132299123100882ANESTH MAJOR VEIN LIGATION199412132299123100902ANESTH ANORECTAL SURGERY199412132299123100904ANESTH PERINEAL SURGERY199412132299123100906ANESTH REMOVAL OF VULVA199412132299123100908ANESTH REMOVAL OF PROSTATE199412132299123100910ANESTH BLADDER SURGERY199412132299123100912ANESTH BLADDER TUMOR SURG199412132299123100914ANESTH REMOVAL OF PROSTATE199412132299123100916ANESTH BLEEDING CONTROL199412132299123100918ANESTH STONE REMOVAL199412132299123100920ANESTH GENITALIA SURGERY199412132299123100922ANESTH SPERM DUCT SURGERY199412132299123100924ANESTH TESTIS EXPLORATION199412132299123100926ANESTH REMOVAL OF TESTIS19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE00928ANESTH REMOVAL OF TESTIS199412132299123100930ANESTH TESTIS SUSPENSION199412132299123100932ANESTH AMPUTATION OF PENIS199412132299123100934ANESTH PENIS NODES REMOVAL199412132299123100936ANESTH PENIS NODES REMOVAL199412132299123100938ANESTH INSERT PENIS DEVICE199412132299123100940ANESTH VAGINAL PROCEDURES199412132299123100942ANESTH SURG ON VAG/URETHRAL199412132299123100944ANESTH VAGINAL HYSTERECTOMY199412132299123100948ANESTH REPAIR OF CERVIX199412132299123100950ANESTH VAGINAL ENDOSCOPY199412132299123100952ANESTH HYSTEROSCOPE/GRAPH199412132299123101120ANESTH PELVIS SURGERY199412132299123101130ANESTH BODY CAST PROCEDURE199412132299123101140ANESTH AMPUTATION AT PELVIS199412132299123101150ANESTH PELVIC TUMOR SURGERY199412132299123101160ANESTH PELVIS PROCEDURE19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE01170ANESTH PELVIS SURGERY199412132299123101200ANESTH HIP JOINT PROCEDURE199412132299123101202ANESTH ARTHROSCOPY OF HIP199412132299123101210ANESTH HIP JOINT SURGERY199412132299123101212ANESTH HIP DISARTICULATION199412132299123101214ANESTH HIP ARTHROPLASTY199412132299123101220ANESTH PROCEDURE ON FEMUR199412132299123101230ANESTH SURGERY OF FEMUR199412132299123101232ANESTH AMPUTATION OF FEMUR199412132299123101234ANESTH RADICAL FEMUR SURG199412132299123101250ANESTH UPPER LEG SURGERY199412132299123101260ANESTH UPPER LEG VEINS SURG199412132299123101270ANESTH THIGH ARTERIES SURG199412132299123101272ANESTH FEMORAL ARTERY SURG199412132299123101274ANESTH FEMORAL EMBOLECTOMY199412132299123101320ANESTH KNEE AREA SURGERY199412132299123101340ANESTH KNEE AREA PROCEDURE19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE01360ANESTH KNEE AREA SURGERY199412132299123101380ANESTH KNEE JOINT PROCEDURE199412132299123101382ANESTH DX KNEE ARTHROSCOPY199412132299123101390ANESTH KNEE AREA PROCEDURE199412132299123101392ANESTH KNEE AREA SURGERY199412132299123101400ANESTH KNEE JOINT SURGERY199412132299123101402ANESTH KNEE ARTHROPLASTY199412132299123101404ANESTH AMPUTATION AT KNEE199412132299123101420ANESTH KNEE JOINT CASTING199412132299123101430ANESTH KNEE VEINS SURGERY199412132299123101432ANESTH KNEE VESSEL SURG199412132299123101440ANESTH KNEE ARTERIES SURG199412132299123101442ANESTH KNEE ARTERY SURG199412132299123101444ANESTH KNEE ARTERY REPAIR199412132299123101462ANESTH LOWER LEG PROCEDURE199412132299123101464ANESTH ANKLE/FT ARTHROSCOPY199412132299123101470ANESTH LOWER LEG SURGERY19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE01472ANESTH ACHILLES TENDON SURG199412132299123101474ANESTH LOWER LEG SURGERY199412132299123101480ANESTH LOWER LEG BONE SURG199412132299123101482ANESTH RADICAL LEG SURGERY199412132299123101484ANESTH LOWER LEG REVISION199412132299123101486ANESTH ANKLE REPLACEMENT199412132299123101490ANESTH LOWER LEG CASTING199412132299123101500ANESTH LEG ARTERIES SURG199412132299123101502ANESTH LWR LEG EMBOLECTOMY199412132299123101520ANESTH LOWER LEG VEIN SURG199412132299123101522ANESTH LOWER LEG VEIN SURG199412132299123101610ANESTH SURGERY OF SHOULDER199412132299123101620ANESTH SHOULDER PROCEDURE199412132299123101622ANES DX SHOULDER ARTHROSCOPY199412132299123101630ANESTH SURGERY OF SHOULDER199412132299123101634ANESTH SHOULDER JOINT AMPUT199412132299123101636ANESTH FOREQUARTER AMPUT19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE01638ANESTH SHOULDER REPLACEMENT199412132299123101650ANESTH SHOULDER ARTERY SURG199412132299123101652ANESTH SHOULDER VESSEL SURG199412132299123101654ANESTH SHOULDER VESSEL SURG199412132299123101656ANESTH ARM-LEG VESSEL SURG199412132299123101670ANESTH SHOULDER VEIN SURG199412132299123101680ANESTH SHOULDER CASTING199412132299123101710ANESTH ELBOW AREA SURGERY199412132299123101712ANESTH UPPR ARM TENDON SURG199412132299123101714ANESTH UPPR ARM TENDON SURG199412132299123101716ANESTH BICEPS TENDON REPAIR199412132299123101730ANESTH UPPR ARM PROCEDURE199412132299123101732ANESTH DX ELBOW ARTHROSCOPY199412132299123101740ANESTH UPPER ARM SURGERY199412132299123101742ANESTH HUMERUS SURGERY199412132299123101744ANESTH HUMERUS REPAIR199412132299123101756ANESTH RADICAL HUMERUS SURG19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE01758ANESTH HUMERAL LESION SURG199412132299123101760ANESTH ELBOW REPLACEMENT199412132299123101770ANESTH UPPR ARM ARTERY SURG199412132299123101772ANESTH UPPR ARM EMBOLECTOMY199412132299123101780ANESTH UPPER ARM VEIN SURG199412132299123101782ANESTH UPPR ARM VEIN REPAIR199412132299123101810ANESTH LOWER ARM SURGERY199412132299123101820ANESTH LOWER ARM PROCEDURE199412132299123101830ANESTH LOWER ARM SURGERY199412132299123101832ANESTH WRIST REPLACEMENT199412132299123101840ANESTH LWR ARM ARTERY SURG199412132299123101842ANESTH LWR ARM EMBOLECTOMY199412132299123101844ANESTH VASCULAR SHUNT SURG199412132299123101850ANESTH LOWER ARM VEIN SURG199412132299123101852ANESTH LWR ARM VEIN REPAIR199412132299123101860ANESTH LOWER ARM CASTING199412132299123101916ANESTH DX ARTERIOGRAPHY19941213229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE01920ANESTH CATHETERIZE HEART199412132299123101922ANESTH CAT OR MRI SCAN199412132299123101935ANESTH PERC IMG DX SP PROC200801012299123101936ANESTH PERC IMG TX SP PROC200801012299123101990SUPPORT FOR ORGAN DONOR199412132299123101996HOSP MANAGE CONT DRUG ADMIN199412132299123101999UNLISTED ANESTH PROCEDURE19850501229912310408TINSJ/RPLC CARDIAC MODULJ SYS20160101229912310409TINSJ/RPLC CAR MODULJ PLS GN20160101229912310410TINSJ/RPLC CAR MODULJ ATR ELT20160101229912310411TINSJ/RPLC CAR MODULJ VNT ELT20160101229912310412TRMVL CARDIAC MODULJ PLS GEN20160101229912310413TRMVL CAR MODULJ TRANVNS ELT20160101229912310414TRMVL & RPL CAR MODULJ PLS GN20160101229912310415TREPOS CAR MODULJ TRANVNS ELT20160101229912310416TRELOC SKIN POCKET PLS GEN20160101229912310417TPRGRMG EVAL CARDIAC MODULJ20160101229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE0418TINTERRO EVAL CARDIAC MODULJ20160101229912310419TDSTRJ NEUROFIBROMA XTNSV20160101229912310420TDSTRJ NEUROFIBROMA XTNSV20160101229912310421TWATERJET PROSTATE ABLTJ CMPL20160101229912310422TTACTILE BREAST IMG UNI/BI20160101229912310423TASSAY SECRETORY TYPE II PLA220160101229912310424TINSJ/RPLC NSTIM APNEA COMPL20160101229912310425TINSJ/RPLC NSTIM APNEA SEN LD20160101229912310426TINSJ/RPLC NSTIM APNEA STM LD20160101229912310427TINSJ/RPLC NSTIM APNEA PLS GN20160101229912310428TRMVL NSTIM APNEA PLS GEN20160101229912310429TRMVL NSTIM APNEA SEN LD20160101229912310430TRMVL NSTIM APNEA STIMJ LD20160101229912310431TRMVL/RPLC NSTIM APNEA PLS GN20160101229912310432TREPOS NSTIM APNEA STIMJ LD20160101229912310433TREPOS NSTIM APNEA SENSING LD20160101229912310434TINTERRO EVAL NPGS APNEA20160101229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE0435TPRGRMG EVAL NPGS APNEA 1 SES20160101229912310436TPRGRMG EVAL NPGS APNEA STUDY20160101229912310437TIMPLTJ SYNTH RNFCMT ABDL WAL20160701229912310439TMYOCRD CONTRAST PRFUJ ECHO20160701229912310440TABLTJ PERC UXTR/PERPH NRV20160701229912310441TABLTJ PERC LXTR/PERPH NRV20160701229912310442TABLTJ PERC PLEX/TRNCL NRV20160701229912310443TR-T SPCTRL ALYS PRST8 TISS20160701229912310444T1ST PLMT DRUG ELUT OC INS20160701229912310445TSBSQT PLMT DRUG ELUT OC INS20160701229912310446TINSJ IMPLTBL GLUCOSE SENSOR20170101229912310447TRMVL IMPLTBL GLUCOSE SENSOR20170101229912310448TREMVL INSJ IMPLTBL GLUC SENS20170101229912310449TINSJ AQUEOUS DRAIN DEV 1ST20170101229912310450TINSJ AQUEOUS DRAIN DEV EACH20170101229912310451TINSJ/RPLCMT AORTIC VENTR SYS20170101229912310452TINSJ/RPLCMT DEV VASC SEAL20170101229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE0453TINSJ/RPLCMT MECH-ELEC NTRFCE20170101229912310454TINSJ/RPLCMT SUBQ ELECTRODE20170101229912310455TREMVL AORTIC VENTR CMPL SYS20170101229912310456TREMVL AORTIC DEV VASC SEAL20170101229912310457TREMVL MECH-ELEC SKIN NTRFCE20170101229912310458TREMVL SUBQ ELECTRODE20170101229912310459TRELOCAJ RPLCMT AORTIC VENTR20170101229912310460TREPOS AORTIC VENTR DEV ELTRD20170101229912310461TREPOS AORTIC CONTRPULSJ DEV20170101229912310462TPRGRMG EVAL AORTIC VENTR SYS20170101229912310463T10004INTERROG AORTIC VENTR SYS2017010122991231FNA BX W/O IMG GDN EA ADDL201901012299123110005FNA BX W/US GDN 1ST LES201901012299123110006FNA BX W/US GDN EA ADDL201901012299123110007FNA BX W/FLUOR GDN 1ST LES201901012299123110008FNA BX W/FLUOR GDN EA ADDL201901012299123110009FNA BX W/CT GDN 1ST LES20190101229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE10010FNA BX W/CT GDN EA ADDL201901012299123110011FNA BX W/MR GDN 1ST LES201901012299123110012FNA BX W/MR GDN EA ADDL201901012299123110021FNA BX W/O IMG GDN 1ST LES20020101229912311307.3810040ACNE SURGERY19780101229912311307.3810060DRAINAGE OF SKIN ABSCESS19780101229912311307.3810061DRAINAGE OF SKIN ABSCESS19780101229912311307.3810080DRAINAGE OF PILONIDAL CYST19780101229912311307.3810081DRAINAGE OF PILONIDAL CYST19780101229912314582.2510120REMOVE FOREIGN BODY19780101229912311307.3810121REMOVE FOREIGN BODY19780101229912312412.7910140DRAINAGE OF HEMATOMA/FLUID19780101229912311307.3810160PUNCTURE DRAINAGE OF LESION19780101229912311307.3810180COMPLEX DRAINAGE WOUND19811001229912312412.7911000DEBRIDE INFECTED SKIN197801012299123111001DEBRIDE INFECTED SKIN ADD-ON19780101229912311307.3811010DEBRIDE SKIN AT FX SITE19970101229912312412.792020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPERAMT PRICE ASC
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE11011DEBRIDE SKIN MUSC AT FX SITE19970101229912312AMT PRICE ASC412.7911012DEB SKIN BONE AT FX SITE19970101229912312412.7911042DEB SUBQ TISSUE 20 SQ CM/ 19840501229912312412.7911043DEB MUSC/FASCIA 20 SQ CM/ 19811001229912312412.7911044DEB BONE 20 SQ CM/ 19811001229912312412.7911045DEB SUBQ TISSUE ADD-ON20110101229912312412.7911046DEB MUSC/FASCIA ADD-ON20110101229912312412.7911047DEB BONE ADD-ON20110101229912312412.7911055TRIM SKIN LESION19980101229912311307.3811056TRIM SKIN LESIONS 2 TO 419980101229912311307.3811057TRIM SKIN LESIONS OVER 419980101229912311307.3811102TANGNTL BX SKIN SINGLE LES201901012299123111103TANGNTL BX SKIN EA SEP/ADDL201901012299123111104PUNCH BX SKIN SINGLE LESION201901012299123111105PUNCH BX SKIN EA SEP/ADDL201901012299123111106INCAL BX SKN SINGLE LES201901012299123111107INCAL BX SKN EA SEP/ADDL20190101229912312020 ASC Fee ScheduleCODES LISTED WITHOUT A RATE ARE REIMBURSED AT 45% OF BILLED CHARGESAttached is the list of procedure codes that are covered forprovider type 36. If the procedure code has an ASC PaymentGroup the group is listed with the effective date and theallowed amount for thegroup.GROUPER
A reminder, the dental procedure codes have an ASCPayment Group listed, but the reimbursement rule is not setup to use the ASC Payment group. The reimbursement rule isset up to look for a ASD rate (a provider percent rate. Foundon the provider panel. If the provider does not have a ASDpercent rate, default pricing (45% of billed amount) isapplied.)CDE PROCDSC PROCEDUREPROC EFFECTIVE DATEPROC END DATE11200REMOVAL OF SKIN TAGS W/1519840501229912311AMT PRICE ASC307.3811201REMOVE SKIN TAGS ADD-ON19811001229912311307.3811300SHAVE SKIN LESION 0.5 CM/ 19930101229912311307.3811301SHAVE SKIN LESION 0.6-1.0 CM19930101229912311307.3811302SHAVE SKIN LESION 1.1-2.0 CM19930101229912311307.3811303SHAVE SKIN LESION 2.0 CM19930101229912311307.3811305SHAVE SKIN LESION 0.5 CM/ 19930101229912311307.3811306SHAVE SKIN LESION 0.6-1.0 CM19930101229912311307.3811307SHAVE SKIN LESION 1.1-2.0 CM19930101229912312412.7911308SHAVE SKIN LESION 2.0 CM19930101229912311307.3811310SHAVE SKIN LESION 0.5 CM/ 19930101229912311307.3811311SHAVE SKIN LESION 0.6-1.0 CM19930101229912311307.3811312SHAVE SKIN
2020 ASC Fee Schedule Attached is the list of procedure codes that are covered for provider type 36. If the procedure code has an ASC Payment Group the group is listed with the effective date and the allowed amount for the group. A reminder, the dental procedure codes have an ASC Payment Group listed, but the reimbursement rule is not set
