HCPCS L0628
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
Current codeLumbar Sacral Orthosis Brace26 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $14.40 | $36.00 |
| Deaconess Medical Center | — | $14.40 | $36.00 |
| Harborview Medical Center | — | $24.95 – $25.12 | $35.64 – $35.88 |
| Mary Bridge Children's Hospital | — | $14.40 | $36.00 |
| MultiCare Auburn Medical Center | — | $14.40 | $36.00 |
| MultiCare Covington Medical Center | — | $14.40 | $36.00 |
| MultiCare Good Samaritan Hospital | — | $14.40 | $36.00 |
| MultiCare Valley Hospital | — | $14.40 | $36.00 |
| Seattle Children's Hospital | $10.81 | $42.90 | $42.90 |
| Tacoma General Allenmore Hospital | — | $14.40 | $36.00 |
| University of Washington Medical Ctr | — | $153 | $218 |
| Yakima Valley Memorial | — | $14.40 | $36.00 |
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
- $28.70 (fee)