HCPCS L2030

Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated

Current codeKnee Orthosis23 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS L2030 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$1,510 – $1,6616 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$1,510 – $1,6618 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$1,541 – $1,6955 plans$1,887$2,696
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$1,541 – $1,8497 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$1,510 – $1,6617 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$1,510 – $1,6617 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$1,510 – $1,6617 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$1,510 – $1,6617 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$1,555 – $1,6617 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$1,541 – $1,6023 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$1,541 – $1,8497 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$1,541 – $2,4657 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$1,541 – $1,6956 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$1,541 – $2,4657 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$1,541 – $1,8498 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$1,541 – $1,8498 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$1,541 – $1,8498 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$1,541 – $1,8498 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$1,510 – $1,6617 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$1,541 – $1,6955 plans——
Virginia Mason Medical CenterSeattle$1,057 – $1,5869 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27———
Yakima Valley MemorialYakimaFile dated 2026-08-27$1,510 – $1,6918 plans——

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
$1,541 (fee)