HCPCS L0486

Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated

Current code29 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

Prices for HCPCS L0486 by hospital
HospitalOther government program rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$1,104$2,761
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$1,104$2,761
Harborview Medical CenterSeattleFile dated 2026-04-01—$2,654$3,792
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$3,414$4,877
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$1,104$2,761
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$1,104$2,761
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$1,104$2,761
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$1,104$2,761
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$1,104$2,761
Olympic Medical CenterPort AngelesFile dated 2026-06-24—$44.00$55.00
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$3,850$5,499
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$6,318$12,150
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$3,850$5,499
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$3,676$5,251
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$6,389$12,286
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$3,676$5,251
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$3,580$5,115
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$6,318$12,150
Seattle Children's HospitalSeattle$3,4601 plan$8,440$8,440
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$3,719$7,749
Swedish IssaquahIssaquahFile dated 2026-04-01—$2,434 – $3,719$5,070 – $7,749
Swedish Medical CenterSeattleFile dated 2026-04-01—$2,434 – $3,719$5,070 – $7,749
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$2,434 – $3,719$5,070 – $7,749
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$1,104$2,761
University of Washington Medical CtrSeattleFile dated 2026-04-01—$3,901$5,573
Virginia Mason Medical CenterSeattle———
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27———
Yakima Valley MemorialYakimaFile dated 2026-08-27———

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
$2,167 (fee)