HCPCS L0630

Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Current codeLumbar Sacral Orthosis Brace24 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

Prices for HCPCS L0630 by hospital
HospitalMedicaid (state program) rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$99.20$248
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$99.20$248
Harborview Medical CenterSeattleFile dated 2026-04-01—$236 – $238$337 – $340
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$99.20$248
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$99.20$248
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$99.20$248
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$99.20$248
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$99.20$248
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$580$829
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$549$1,055
Seattle Children's HospitalSeattle$1711 plan$677$677
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$99.20$248
University of Washington Medical CtrSeattleFile dated 2026-04-01—$302 – $304$431 – $434
Yakima Valley MemorialYakimaFile dated 2026-08-27—$99.20$248

Lowest and highest amounts each hospital lists for this code during a hospital stay, 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
$194 (fee)