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

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

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http://www.wpsmedicare.com<br />

<strong>WPS</strong> <strong>Medicare</strong><br />

Ambulatory Surgical Center (<strong>ASC</strong>) <strong>Fee</strong> <strong>Schedule</strong> <strong>for</strong> <strong>Iowa</strong> <strong>CBSA</strong> <strong>26980</strong><br />

Effective January 1, 2011<br />

All Current Procedural Terminology (CPT) codes and descriptors are copyrighted<br />

2009 by the American Medical Association. All Rights Reserved. No fee schedules,<br />

basic units, relative values, or related listings are included in CPT. The AMA<br />

assumes no liability <strong>for</strong> the data contained herein. Applicable FARS/DFARS<br />

restrictions apply to government use. All rights reserved.<br />

HCPCS MOD PROC IND AMOUNT FC MOD AMOUNT FB MOD AMOUNT<br />

55200 S 903.83 0.00 0.00<br />

55250 S 903.83 0.00 0.00<br />

55400 S 903.83 0.00 0.00<br />

55450 S 215.06 0.00 0.00<br />

55500 S 903.83 0.00 0.00<br />

55520 S 903.83 0.00 0.00<br />

55530 S 903.83 0.00 0.00<br />

55535 S 1,259.61 0.00 0.00<br />

55540 S 1,259.61 0.00 0.00<br />

55550 S 1,821.89 0.00 0.00<br />

55600 S 903.83 0.00 0.00<br />

55680 S 903.83 0.00 0.00<br />

55700 S 496.11 0.00 0.00<br />

55705 S 496.11 0.00 0.00<br />

55706 S 496.11 0.00 0.00<br />

55720 S 1,002.74 0.00 0.00<br />

55725 S 1,002.74 0.00 0.00<br />

55860 S 764.95 0.00 0.00<br />

55870 S 83.48 0.00 0.00<br />

55873 S 6,448.86 0.00 0.00<br />

55875 S 1,422.56 0.00 0.00<br />

55876 S 75.47 0.00 0.00<br />

55920 S 1,008.43 0.00 0.00<br />

56405 S 49.75 0.00 0.00<br />

56420 S 62.25 0.00 0.00<br />

56440 S 787.39 0.00 0.00<br />

56441 S 787.39 0.00 0.00<br />

56442 S 787.39 0.00 0.00<br />

56501 S 67.45 0.00 0.00<br />

56515 S 830.00 0.00 0.00<br />

56605 S 39.07 0.00 0.00<br />

56606 S 16.03 0.00 0.00<br />

56620 S 787.39 0.00 0.00<br />

56625 S 787.39 0.00 0.00<br />

56700 S 787.39 0.00 0.00<br />

56740 S 787.39 0.00 0.00<br />

56800 S 787.39 0.00 0.00<br />

56805 S 787.39 0.00 0.00<br />

56810 S 787.39 0.00 0.00<br />

56820 S 50.42 0.00 0.00<br />

56821 S 62.25 0.00 0.00<br />

PROCEDURE INDICATORS: S = SURGICAL PROCEDURE,<br />

A = ANCILLARY SERVICE, C = CARRIER PRICED<br />

70 of 100

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