Ambulatory Surgical Centers (ASC)

Provider Representative: Karen Murphy Tel. (571) 348-5933
Email: karen.murphy3@gainwelltechnologies.com

Reimbursement

Ambulatory Surgical Centers are reimbursed using a level system. There are currently nine (9) levels that each are associated with a fee. CPT codes are assigned on of the 9 levels. Reimbursement is 75% of the applicable fee for that level, see table below.

ASC Level	Fee	ASC Percent	Provider Reimbursement
Level 1	$340.00	75%	$255.00
Level 2	$455.00	75%	$341.25
Level 3	$520.00	75%	$390.00
Level 4	$643.00	75%	$482.25
Level 5	$731.00	75%	$548.25
Level 6	$840.00	75%	$630.00
Level 7	$1,015.00	75%	$761.25
Level 8	$989.00	75%	$741.75
Level 9	$1,366.00	75%	$1,024.50
Level 10	$1672.00	75%	$1254.00

Please find a list of the current CPT codes and the assigned level in this ASC pricing document. Any CPT code not on this list is not covered when provided by an ASC and will not be reimbursed. There is no plan to modify this pricing at this time.