HCPCS L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

Current code24 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L2628 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$2,618 – $2,7812 plans$1,309$3,272
Deaconess Medical CenterSpokaneFile dated 2026-08-27$2,323 – $2,3892 plans$1,309$3,272
Harborview Medical CenterSeattleFile dated 2026-04-01—$3,145$4,492
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$2,140 – $2,6186 plans$1,309$3,272
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$1,930 – $2,3893 plans$1,309$3,272
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$1,930 – $2,3893 plans$1,309$3,272
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$1,930 – $2,3893 plans$1,309$3,272
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$2,3562 plans$1,309$3,272
Seattle Children's HospitalSeattle$3,731 – $6,63398 plans$6,910$6,910
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$1,930 – $2,3893 plans$1,309$3,272
Yakima Valley MemorialYakimaFile dated 2026-08-27$1,8321 plan$1,309$3,272

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
$2,567 (fee)