HCPCS G0257

Unscheduled or emergency dialysis treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility

Current codeHemodialysis40 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS G0257 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$779 – $8576 plans$774$1,935
Deaconess Medical CenterSpokaneFile dated 2026-08-27$750 – $8248 plans$1,227$3,068
EvergreenHealth Medical CenterKirkland$779 – $7955 plans$2,198$2,748
Harborview Medical CenterSeattleFile dated 2026-04-01$795 – $8745 plans$2,461$3,515
Highline Medical CenterBurienFile dated 2026-02-28$779 – $89611 plans$973$3,188
Island HospitalAnacortes$819 – $86811 plans——
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$765 – $9187 plans$3,632$5,188
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01$788 – $8576 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$785 – $8637 plans$774$1,935
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$781 – $8597 plans$774$1,935
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$781 – $8597 plans$774$1,935
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$785 – $8637 plans$774$1,935
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$772 – $8247 plans$1,227$3,068
Olympic Medical CenterPort AngelesFile dated 2026-06-24$860 – $1,1065 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$797 – $8293 plans$690$1,379
PeaceHealth Southwest Medical CenteVancouver$761 – $87513 plans$4,112 – $4,235$6,326 – $6,516
PeaceHealth St John Medical CenterLongview$637 – $89814 plans$2,008 – $2,309$3,089 – $3,552
PeaceHealth St Joseph Medical CenterBellingham$815 – $8978 plans$1,824 – $1,879$2,806 – $2,890
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$765 – $9187 plans$1,698 – $3,265$2,425 – $4,664
Providence Centralia HospitalCentraliaFile dated 2026-04-01$795 – $1,2727 plans——
Providence Holy Family HospitalSpokaneFile dated 2026-04-01$765 – $8415 plans$2,286 – $3,891$3,266 – $5,558
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$782 – $8606 plans$770$1,480
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01$765 – $8416 plans$1,191$1,702
Providence St Peter HospitalOlympiaFile dated 2026-04-01$789 – $1,2637 plans$799$1,537
Skagit Valley HospitalMount Vernon$700 – $735at least 4 plans$2,000$2,500
St Anthony HospitalGig HarborFile dated 2026-02-28$793 – $91212 plans$970$3,188
St Clare HospitalLakewoodFile dated 2026-02-28$793 – $91212 plans$919$3,188
St Elizabeth HospitalEnumclawFile dated 2026-02-28$574 – $70112 plans$1,126$3,188
St Francis Community HospitalFederal WayFile dated 2026-02-28$779 – $89612 plans$1,000$3,188
St Joseph Medical CenterTacomaFile dated 2026-02-28$790 – $91212 plans$1,056$3,188
St Michael Medical CenterSilverdaleFile dated 2026-02-28$815 – $88110 plans$1,407$3,188
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$782 – $9388 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$797 – $9568 plans$1,092 – $2,001$2,274 – $4,168
Swedish Medical CenterSeattleFile dated 2026-04-01$795 – $9548 plans$1,092 – $2,001$2,274 – $4,168
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$795 – $9548 plans$1,092 – $2,001$2,274 – $4,168
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$785 – $8637 plans$774$1,935
University of Washington Medical CtrSeattleFile dated 2026-04-01$795 – $8745 plans$2,108$3,012
Virginia Mason Medical CenterSeattle$534 – $8009 plans$254 – $1,271$499 – $2,492
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27———
Yakima Valley MemorialYakimaFile dated 2026-08-27$803 – $8998 plans$1,029$2,572

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.

Hospital outpatient payment (national)
$701 (APC 5401)