HCPCS L2650

Addition to lower extremity, pelvic and thoracic control, gluteal pad, each

Current code23 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 L2650 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$158 – $1,22916 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$220 – $7659 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$294 – $3682 plans$225$322
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$277 – $5165 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$158 – $1,3497 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$154 – $79417 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$154 – $79417 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$179 – $79412 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$176 – $76310 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$169 – $50610 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$285 – $6109 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$311 – $6875 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$221 – $4277 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$156 – $6008 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$276 – $6747 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$276 – $4087 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$276 – $6579 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$276 – $6579 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$154 – $79417 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$294 – $5775 plans——
Virginia Mason Medical CenterSeattle$176 – $6397 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$4641 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$158 – $47713 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
$184 (fee)