HCPCS L0628 at University of Washington Medical Ctr

Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

University of Washington Medical Ctr, Seattle

Description from CMS's HCPCS Level II code file.

What University of Washington Medical Ctr publishes for this code: as an outpatient

University of Washington Medical Ctr’s prices for HCPCS L0628, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$45.92 – $90.015 plans	—
Medicare AdvantageInsurer rates	$28.70 – $31.575 plans	—
Cash pricePaying yourself, without insurance	$153	—
List priceBefore any discount; few people pay it	$218	—

Lowest and highest amounts University of Washington Medical Ctr lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-04-01. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in Seattle (King County) for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS L0628 at University of Washington Medical Ctr
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS L0628 at every Washington hospital, with Medicare’s reference amounts.