Table A2-1.
Ambulatory surgery center (ASC) payment rates
CPT Code | ASC Payment, $ |
PFS*- Facility, $ |
Total ASC (ASC payment + PFS), $ |
||||||
---|---|---|---|---|---|---|---|---|---|
Medicare (M) |
Beneficiary (B) |
Total (M+B) |
Medicare (M) |
Beneficiary (B) |
Total (M+B) |
Beneficiary (B) |
Medicare (M) |
Total (M+B) |
|
Colonoscopy without polypectomy | |||||||||
45378 | 357 | 89 | 446 | 158 | 39 | 197 | 129 | 514 | 643 |
G0105 | 335 | 111 | 446 | 158 | 39 | 197 | 151 | 492 | 643 |
G0121 | 335 | 111 | 446 | 158 | 39 | 197 | 151 | 492 | 643 |
Colonoscopy with polypectomy | |||||||||
45380 | 357 | 89 | 446 | 188 | 47 | 235 | 136 | 545 | 681 |
45381 | 357 | 89 | 446 | 178 | 44 | 222 | 134 | 534 | 668 |
45382 | 357 | 89 | 446 | 239 | 60 | 299 | 149 | 596 | 745 |
45383 | 357 | 89 | 446 | 246 | 61 | 307 | 151 | 602 | 753 |
45384 | 357 | 89 | 446 | 198 | 49 | 247 | 139 | 554 | 693 |
45385 | 357 | 89 | 446 | 223 | 56 | 279 | 145 | 580 | 725 |
Pathology | |||||||||
88305 | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Physician fee schedule