Washington All-Payer Claims Database (WA-APCD)

Website Cost Metrics

WA-APCD Inpatient Services

SERVICE_ID / SERVICE_DESC / SERVICE_PRICE_METHOD_NAME / Common_Name / Technical_Name
1 / Coronary Angioplasty PTCA w/o AMI (minor or moderate severity of illness) / Inpatient APR / Cardiac Surgery to Unblocked Blood Vessels: Inpatient / Coronary Angioplasty: Inpatient
2 / Coronary bypass (moderate severity of illness) / Inpatient APR / Cardiac Surgery to Improve Blood Flow to Heart / Coronary Bypass
3 / Total hip replacement (minor or moderate severity of illness) / Inpatient APR / Hip Replacement Surgery / Total Hip Replacement
4 / Total Knee Replacement (minor or moderate severity of illness) / Inpatient APR / Knee Replacement Surgery / Total Knee Replacement
5 / Spinal fusion (minor or moderate severity of illness) / Inpatient APR / Spine Fusion Surgery / Spinal Fusion
7 / Bilateral mastectomy (minor or moderate severity of illness) / Inpatient APR / Breast Removal, Both / Mastectomy: Bilateral
8 / Unilateral mastectomy (minor or moderate severity of illness) / Inpatient APR / Breast Removal, One / Masectomy: Unilateral
9 / Gastric Bypass (minor or moderate severity of illness) / Inpatient APR / Weight Loss, Stomach Bypass Surgery: Inpatient / Gastric Bypass
11 / Sleeve Gastrectomy (minor or moderate severity of illness) / Inpatient APR / Weight Loss, Stomach Sleeve Surgery: Inpatient / Sleeve Gastrectomy
13 / Prostatectomy / Inpatient APR / Prostate Removal Surgery / Prostatectomy
14 / Hysterectomy / Inpatient APR / Hysterectomy: Uterus and Cervix Removal / Total Hysterectomy
18 / Cesarean Section (minor severity) / Inpatient APR / Delivery of Baby by C-Section / Cesarean Section
19 / Vaginal Delivery (minor severity) / Inpatient APR / Delivery of Baby Routine Vaginal / Vaginal Delivery

WA-APCD Outpatient/Ambulatory Care Center Services

SERVICE_ID / SERVICE_DESC / SERVICE_PRICE_METHOD_NAME / Common Name / Technical Name
88 / Biospy of prostate with ultrasound guidance / Outpatient Diagnostic / Prostate Tissue Sample to Check for Cancer / Transrectal Ultrasound and Biopsy of Prostrate
51 / Bone density test / Outpatient Diagnostic / Bone Scan / Bone Mineral Density Scan
20 / Breast biopsy with guidance / Outpatient Surgery / Breast Tissue Sample to Check for Cancer / Breast Biopsy Including Ultrasound Guidance
70 / Cardiac catherization / Outpatient Surgery / Heart X-ray with Dye / Coronary Artery Angiogram
44 / Cataract removal / Outpatient Surgery / Cataract Surgery to Restore Vision / Cataract Removal with Implant of Lens
28 / Colonoscopy (diagnostic) / Outpatient Surgery / Colon Scope Exam / Diagnostic Colonoscopy
30 / Colonoscopy (remove tumor with snare technique) / Outpatient Surgery / Colon Scope Exam and Remove Abnormal Growths / Colonoscopy with Lesion Removal
29 / Colonoscopy (with biopsy) / Outpatient Surgery / Colon Scope Exam and Tissue Sample / Colonoscopy and Biopsy
31 / Cystoscopy - bladder/urethra endoscopy / Outpatient Surgery / Bladder and Urine Tract Scope Exam / Cystoscopy of Bladder/Urethra
69 / Echocardiogram / Outpatient Diagnostic / Heart Echo Imaging Scan / Echocardiogram
82 / Emergency department visit (moderate severity) / Outpatient Diagnostic / Emergency Room Visit / Emergency Department Visit: Moderate Severity
37 / Epidural injection to relieve pain - back / Outpatient Diagnostic / Back Pain Relief Injection / Spine Epidural Injection
26 / Gastric Bypass: Laparoscopic / Outpatient Surgery / Weight Loss, Stomach Bypass Surgery: Outpatient / Gastric Bypass: Laparoscopic
35 / Hysterectomy laparoscopic / Outpatient Surgery / Hysterectomy: Uterus and Cervix Removal / Total Hysterectomy: Laparoscopic
89 / Hysterosalpingography (HSG) / Outpatient Diagnostic / Infertility: X-ray to Evaluate / Hysterosalpingogram (HSG)
34 / Hysteroscopy with biopsy with or without D&C / Outpatient Surgery / Vagina Scope Exam and Tissue Sample / Hysteroscopy with Biopsy
36 / Hysteroscopy with removal of ovaries/fallopian tubes / Outpatient Surgery / Ovaries/Fallopian Tubes Removal Surgery / Hysteroscopy with Salpingo-oophorectomy
23 / Joint injection with ultrasound guidance / Outpatient Diagnostic / Hip: Drain Fluid / Drain/Injection Joint with Ultrasound Guidance
22 / Joint injection without ultrasound guidance / Outpatient Diagnostic / Knee: Drain Fluid / Drain/Injection Joint without Ultrasound Guidance
24 / Knee Arthroscopy / Outpatient Surgery / Knee Scope and Surgery / Knee Arthroscopy
94 / Laparoscopic excision of lesions/cysts (endometriosis tx) / Outpatient Surgery / Uterine Lining Surgery to Remove Cysts / Remove Uterine Lesions/Cycsts: Laparoscopic
27 / Laparoscopic gastric sleeve / Outpatient Surgery / Weight Loss, Stomach Sleeve Surgery: Outpatient / Sleeve Gastrectomy: Laparoscopic
95 / Laparoscopic tubal ligation / Outpatient Surgery / Tubal Ligation: Laparoscopic
99 / Laproscopic radical prostatectomy / Outpatient Surgery / Prostate Removal Surgery: Outpatient / Radical Prostatectomy: Laproscopic
42 / Laser trabeculoplasty / Outpatient Surgery / Eye Pressure Repair with Laser Surgery / Glaucoma: Laser Trabeculoplasty Surgery
91 / Mammogram digital diagnostic, single breast / Outpatient Diagnostic / Breast Cancer Mammogram Exam / Diagnostic Digital Mammogram: Unilateral
90 / Mammogram digital screening / Outpatient Diagnostic / Breast Cancer Mammogram Screening / Screening Digital Mammogram
45 / MRI of lower spine without contrast / Outpatient Diagnostic / Spine MRI Scan / MRI of the Spine
21 / Partial mastectomy or lumpectomy / Outpatient Surgery / Breast Tumor and Tissue Removal / Partial Mastectomy
43 / Post-cataract laser surgery / Outpatient Surgery / Cataract Follow-up Surgery After Lens Implant / After-Cataract Laser Surgery
98 / Prostatectomy / Outpatient Surgery / Prostate Tissue Removal Surgery / Prostatectomy (TURP)
66 / PTCA with Stent / Outpatient Surgery / Cardiac Surgery to Unblock Blood Vessels: Outpatient / Coronary Angioplasty: Outpatient
41 / Spinal decompression laminectomy (spinal stenosis) / Outpatient Surgery / Spinal Stenosis/Back Pain Surgery / Laminectomy
40 / Spinal decompression laminotomy (herniated disc) / Outpatient Surgery / Spine Surgery for Torn Disc / Disectomy
97 / Total hip replacement / Outpatient Surgery / Hip Replacement Surgery: Outpatient / Total Hip Replacement: Outpatient
96 / Total Knee replacement / Outpatient Surgery / Knee Replacement Surgery: Outpatient / Total Knee Replacement: Outpatient
93 / Total mastectomy / Outpatient Surgery / Removal of the Breast / Total Mastectomy: Outpatient
100 / Transvaginal ultrasound (non-obstetric) / Outpatient Diagnostic / Reproductive Organs Imaging Exam / Transvaginal Ultrasound: Non-obstetric
49 / Transvaginal ultrasound (obstetric) / Outpatient Diagnostic / Vaginal Imaging Exam: Pregnancy / Transvaginal Ultrasound First Trimester
50 / Ultrasound uterus (per fetus) / Outpatient Diagnostic / Pregnancy Image Scan of Fetus / Obstetrical Ultasound of Fetus
25 / Upper GI endoscopic biopsy / Outpatient Surgery / Digestive System: Scope Exam and Tissue Sample / Upper Endoscopy of Esophagus, Stomach and Duodenum (EGD)
48 / Upper GI esophagram / Outpatient Diagnostic / Digestive System X-ray / Esophagram
46 / X-ray of hip (two or more views) / Outpatient Diagnostic / Hip X-ray / X-ray of Hip: 2+ Views

WA-APCD Ambulatory/Office Services: County-level Reportable

SERVICE_ID / SERVICE_DESC / SERVICE_PRICE_METHOD_NAME / Common Name / Technical Name
74 / Acupuncture 15 minutes / Professional / Accupuncture Visit / Accupuncture Visit: 15 Minutes
77 / Apply topical fluoride varnish / Professional / Tooth Decay Prevention with Fluoride Gel / Fluoride Varnish
68 / Cardiac stress test / Professional / Heart Test Using Treadmill/Exercise / Cardiovascular Stress Test
75 / Chiropractic manipulation, spinal (1-2 regions) / Professional / Chiropractor Visit / Chiropractor Manipulation: 1-2 Regions
58 / Chlamydia screening / Professional / Sexually Transmitted Disease (STD) Swab Test / Chlamydia Screening
86 / Comprehensive preventive visit, age 12-17 / Professional / Check-up Exam: Teens Age 12-17 / Preventive Visit Ages 12-17
84 / Comprehensive preventive visit, age 1-4 / Professional / Check-up Exam: Children Age 1-4 / Preventive Visit Ages 1-4
83 / Comprehensive preventive visit, age 40-64 / Professional / Check-up Exam: Adult / Preventive Visit Age 40-64
85 / Comprehensive preventive visit, age 5-11 / Professional / Check-up Exam: Children Age 5-11 / Preventive Visit Ages 5-11
57 / Congenital hypothyroidism screening / Professional / Thyroid Disorder Blood Test / Congenital Hypothyroidism Screening
67 / Electrocardiogram / Professional / Heart Rhythm Test (EKG) / Electrocardiogram
55 / Fasting blood sugar test / Professional / Blood Sugar Test / Fasting Blood Glucose Test
54 / Fecal occult blood testing (FOBT) / Professional / Colorectal Cancer Stool Test / Fecal Hemoglobin Blood Test
65 / Hearing screening test / Professional / Hearing Test for Infants / Hearing Test
52 / Lipid panel / Professional / Cholesterol Blood Test / Lipid Panel
76 / Office visit, after hours and weekends / Professional / Doctor Office Visit: Evening or Weekend / Office Visit: Evening, Weekend, Holiday
92 / Office visit, established patient, low complexity / Professional / Doctor Office Visit: Current Patient / Office Visit Existing Patient: 30 Minutes
78 / Office visit, new patient, low complexity / Professional / Doctor Office Visit: New Patient / Office Visit New Patient: 30 Minutes
59 / PAP test, cervical cancer screening / Professional / PAP Test / PAP Test for Cervical Cancer
72 / Physical therapy evaluation visit / Professional / Physical Therapy Treatment Plan / Physical Therapy Evaluation and Treatment Plan
73 / Physical therapy exercises / Professional / Physical Therapy Session / Therapeutic Exercises
56 / Prostate cancer screening test (PSA) / Professional / Prostate Cancer Blood Test / PSA Screening Test
71 / Psychiatric brief emotional/behavioral assessment / Professional / Mental Health Disorder Screening / Brief Emotional/Behavioral Health Assessment
60 / Psychiatric diagnostic evaluation / Professional / Mental Health Evaluation Visit / Psychiatric Diagnostic Evaluation
62 / Psychiatric family therapy / Professional / Mental Health Family Counseling Visit / Psychotherapy Patient and Family: 60 Minutes
63 / Psychiatric group therapy / Professional / Mental Health Counseling: Group Visit / Group Psychotherapy
61 / Psychiatric individual therapy / Professional / Mental Health Visit / Psychiatric Therapy: Individual
64 / Routine eye exam, new patient / Professional / Eye Exam / Eye Exam New Patient
80 / Telehealth visit / Professional / Doctor Visit Online Using Audio and Video / Telehealth Visit
79 / Urgent care center visit, global fee / Professional / Urgent Care Center Visit / Urgent Care Center Visit
53 / Urine pregnancy test / Professional / Pregnancy Test / Urine Pregnancy Test

*Common and technical names are preliminary. Professional = reported at geographic level only.Page 1 of 4