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HCPCS A5057

Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each

Current codeOstomy2 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$26.822 plans——
Virginia Mason Medical CenterSeattle$37.80 – $50.409 plans$32.13$63.00

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

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$13.68 (fee)