HCPCS L3650

Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf

Current code41 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare (traditional): Traditional Medicare. Applies only to people on original Medicare.

Prices for HCPCS L3650 by hospital
HospitalMedicare (traditional) rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
Cascade Valley HospitalArlington—$47.60 – $52.00$59.50 – $65.00
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
Harborview Medical CenterSeattleFile dated 2026-04-01—$24.49 – $62.20$34.99 – $88.85
Highline Medical CenterBurienFile dated 2026-02-28—$11.43 – $14.88$37.41 – $48.70
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$12.70 – $44.21$18.14 – $63.16
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
Olympic Medical CenterPort AngelesFile dated 2026-06-24—$20.80$26.00
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$27.27 – $94.97$38.96 – $136
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$16.06 – $55.91$30.88 – $108
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$27.27 – $94.97$38.96 – $136
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$25.67 – $89.38$36.67 – $128
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$17.06 – $59.40$32.81 – $114
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$25.67 – $89.38$36.67 – $128
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$16.21 – $548$23.16 – $783
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$16.06 – $55.91$30.88 – $108
Skagit Valley HospitalMount Vernon—$47.60 – $52.00$59.50 – $65.00
St Anthony HospitalGig HarborFile dated 2026-02-28—$11.38 – $14.82$37.41 – $48.70
St Clare HospitalLakewoodFile dated 2026-02-28—$10.79 – $14.04$37.41 – $48.70
St Elizabeth HospitalEnumclawFile dated 2026-02-28—$13.22 – $17.21$37.41 – $48.70
St Francis Community HospitalFederal WayFile dated 2026-02-28—$11.75 – $15.29$37.41 – $48.70
St Joseph Medical CenterTacomaFile dated 2026-02-28—$12.40 – $16.13$37.41 – $48.70
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$16.52 – $21.50$37.41 – $48.70
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$10.56 – $91.95$22.00 – $192
Swedish IssaquahIssaquahFile dated 2026-04-01—$10.56 – $148$22.00 – $308
Swedish Medical CenterSeattleFile dated 2026-04-01—$10.56 – $94.08$22.00 – $196
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$10.56 – $110$22.00 – $228
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$23.60 – $36.40$59.00 – $91.00
Three Rivers HospitalBrewster$16.61 – $2271 plan$24.56 – $336$24.56 – $336
University of Washington Medical CtrSeattleFile dated 2026-04-01—$21.20 – $109$30.28 – $156
Yakima Valley MemorialYakimaFile dated 2026-08-27—$8.80 – $36.40$22.00 – $91.00

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
$71.08 (fee)