HCPCS L5622
Addition to lower extremity, test socket, knee disarticulation
Current code24 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $502 – $552 | — | — |
| Deaconess Medical Center | $502 – $552 | — | — |
| Harborview Medical Center | $512 – $563 | $625 – $627 | $893 – $896 |
| Kadlec Regional Medical Center | $512 – $615 | — | — |
| Mary Bridge Children's Hospital | $502 – $552 | — | — |
| MultiCare Auburn Medical Center | $502 – $552 | — | — |
| MultiCare Covington Medical Center | $502 – $552 | — | — |
| MultiCare Good Samaritan Hospital | $502 – $552 | — | — |
| MultiCare Valley Hospital | $517 – $552 | — | — |
| Overlake Hospital Medical Center & Clinics | $512 – $533 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $512 – $615 | — | — |
| Providence Centralia Hospital | $512 – $819 | — | — |
| Providence Regional Medical Center Everett | $512 – $563 | — | — |
| Providence St Peter Hospital | $512 – $819 | — | — |
| Seattle Children's Hospital | — | $1,440 | $1,440 |
| Swedish Edmonds Hospital | $512 – $615 | — | — |
| Swedish Issaquah | $512 – $615 | — | — |
| Swedish Medical Center | $512 – $615 | — | — |
| Swedish Medical Center / Cherry Hill | $512 – $615 | — | — |
| Tacoma General Allenmore Hospital | $502 – $552 | — | — |
| University of Washington Medical Ctr | $512 – $563 | $794 | $1,134 |
| Virginia Mason Medical Center | $351 – $527 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $502 – $562 | — | — |
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
- $512 (fee)