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Washington State Department of Labor and Industries
Ambulatory Surgery Center Fee Schedule
Jul 2015 ASC
CPTJ
Payment
HOPES
Code
Amount
10021 Not covered
10022 Not covered
10030
×799.03
10040
Bundled
10060
×167.34
10061
×149.45
10080
×149.45
10081
×288.50
10120
×178.74
10121
×1,237.73
10140
×203.33
10160
×164.35
10180
×1,509.35
11000
×48.58
11001
Bundled
11010
×762.69
11011
×349.30
11012
×762.69
11042
×261.26
11043
×261.26
11044
×762.69
11045
Bundled
11046
Bundled
11047
Bundled
11055
Bundled...
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