HCPCS L0628 at Yakima Valley Memorial

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

Yakima Valley Memorial, Yakima

Description from CMS's HCPCS Level II code file.

What Yakima Valley Memorial publishes for this code: as an outpatient

Yakima Valley Memorial’s prices for HCPCS L0628, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$17.64 – $24619 plans	—
Medicare AdvantageInsurer rates	$28.13 – $31.508 plans	—
Cash pricePaying yourself, without insurance	$14.40	—
List priceBefore any discount; few people pay it	$36.00	—

Lowest and highest amounts Yakima Valley Memorial lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-27. This is one line of a bill; most care brings several.

What Yakima Valley Memorial publishes for this code: during a hospital stay

Yakima Valley Memorial’s prices for HCPCS L0628, during a hospital stay
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$20.161 plan	—
Cash pricePaying yourself, without insurance	$14.40	—
List priceBefore any discount; few people pay it	$36.00	—

Lowest and highest amounts Yakima Valley Memorial lists for this code during a hospital stay, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-27. 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 the rest of Washington 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 Yakima Valley Memorial
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.