HCPCS L3677

Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Current code9 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 L3677 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$103 – $1335 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$2641 plan——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$97.21 – $1115 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$97.21 – $1115 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$1601 plan——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01—$190$381
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$97.21 – $1115 plans——
Virginia Mason Medical CenterSeattle$3031 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$116 – $1335 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

CMS publishes no national amount for this code.