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HCPCS A4263

Permanent, long term, non-dissolvable lacrimal duct implant, each

Current code25 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

HospitalMedicaid (state program) rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$355 – $839$888 – $2,097
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$355 – $839$888 – $2,097
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$25.49 – $303$36.42 – $432
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$355 – $839$888 – $2,097
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$355 – $839$888 – $2,097
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$355 – $839$888 – $2,097
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$355 – $839$888 – $2,097
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$355 – $839$888 – $2,097
Olympic Medical CenterPort AngelesFile dated 2026-06-24—$192$239
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$54.76 – $425$78.23 – $607
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$32.24 – $450$62.00 – $866
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$54.76 – $425$78.23 – $607
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$51.53 – $403$73.62 – $575
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$34.25 – $498$65.87 – $958
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$51.53 – $403$73.62 – $575
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$32.55 – $350$46.50 – $500
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$32.24 – $450$62.00 – $866
Seattle Children's HospitalSeattle$38.43 – $1441 plan$153 – $570$153 – $570
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$21.20 – $309$44.17 – $643
Swedish IssaquahIssaquahFile dated 2026-04-01—$21.20 – $309$44.17 – $643
Swedish Medical CenterSeattleFile dated 2026-04-01—$21.20 – $309$44.17 – $643
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$21.20 – $309$44.17 – $643
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$342 – $839$854 – $2,097
Virginia Mason Medical CenterSeattle—$32.64 – $87.21$64.00 – $171
Yakima Valley MemorialYakimaFile dated 2026-08-27—$236 – $579$591 – $1,447

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.