(ASC) Fee Schedule for Iowa CBSA 26980 - WPS Medicare

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WPS Medicare
Ambulatory Surgical Center (ASC) Fee Schedule for Iowa CBSA 26980
Effective January 1, 2011
All Current Procedural Terminology (CPT) codes and descriptors are copyrighted
2009 by the American Medical Association. All Rights Reserved. No fee schedules,
basic units, relative values, or related listings are included in CPT. The AMA
assumes no liability for the data contained herein. Applicable FARS/DFARS
restrictions apply to government use. All rights reserved.
HCPCS MOD PROC IND AMOUNT FC MOD AMOUNT FB MOD AMOUNT
54415 S 1,368.80 0.00 0.00
54416 S 10,000.61 5,916.48 1,832.36
54420 S 1,368.80 0.00 0.00
54435 S 1,368.80 0.00 0.00
54440 S 1,368.80 0.00 0.00
54450 S 122.30 0.00 0.00
54500 S 597.87 0.00 0.00
54505 S 903.83 0.00 0.00
54512 S 903.83 0.00 0.00
54520 S 903.83 0.00 0.00
54522 S 903.83 0.00 0.00
54530 S 1,259.61 0.00 0.00
54550 S 1,259.61 0.00 0.00
54560 S 903.83 0.00 0.00
54600 S 903.83 0.00 0.00
54620 S 903.83 0.00 0.00
54640 S 1,259.61 0.00 0.00
54660 S 903.83 0.00 0.00
54670 S 903.83 0.00 0.00
54680 S 903.83 0.00 0.00
54690 S 1,821.89 0.00 0.00
54692 S 2,707.33 0.00 0.00
54700 S 903.83 0.00 0.00
54800 S 174.56 0.00 0.00
54830 S 903.83 0.00 0.00
54840 S 903.83 0.00 0.00
54860 S 903.83 0.00 0.00
54861 S 903.83 0.00 0.00
54865 S 903.83 0.00 0.00
54900 S 903.83 0.00 0.00
54901 S 903.83 0.00 0.00
55000 S 68.79 0.00 0.00
55040 S 1,259.61 0.00 0.00
55041 S 1,259.61 0.00 0.00
55060 S 903.83 0.00 0.00
55100 S 495.51 0.00 0.00
55110 S 903.83 0.00 0.00
55120 S 903.83 0.00 0.00
55150 S 903.83 0.00 0.00
55175 S 903.83 0.00 0.00
55180 S 903.83 0.00 0.00
PROCEDURE INDICATORS: S = SURGICAL PROCEDURE,
A = ANCILLARY SERVICE, C = CARRIER PRICED
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