HCPCS L5628
Addition to lower extremity, test socket, hemipelvectomy
Current code24 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $638 – $4,949 | — | — |
| Deaconess Medical Center | $886 – $3,080 | — | — |
| Harborview Medical Center | $1,184 – $1,480 | $907 | $1,295 |
| Kadlec Regional Medical Center | $1,116 – $2,079 | — | — |
| Mary Bridge Children's Hospital | $638 – $5,432 | — | — |
| MultiCare Auburn Medical Center | $620 – $3,198 | — | — |
| MultiCare Covington Medical Center | $620 – $3,198 | — | — |
| MultiCare Good Samaritan Hospital | $720 – $3,198 | — | — |
| MultiCare Valley Hospital | $709 – $3,074 | — | — |
| Overlake Hospital Medical Center & Clinics | $679 – $2,036 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,146 – $2,456 | — | — |
| Providence Centralia Hospital | $1,251 – $2,768 | — | — |
| Providence Regional Medical Center Everett | $888 – $1,717 | — | — |
| Providence St Peter Hospital | $629 – $2,417 | — | — |
| Seattle Children's Hospital | $1,123 – $1,997 | $2,080 | $2,080 |
| Swedish Edmonds Hospital | $1,110 – $2,715 | — | — |
| Swedish Issaquah | $1,110 – $1,643 | — | — |
| Swedish Medical Center | $1,110 – $2,644 | — | — |
| Swedish Medical Center / Cherry Hill | $1,110 – $2,644 | — | — |
| Tacoma General Allenmore Hospital | $620 – $3,198 | — | — |
| University of Washington Medical Ctr | $1,184 – $2,321 | $1,145 | $1,636 |
| Virginia Mason Medical Center | $709 – $2,574 | — | — |
| Wellfound Behavioral Health Hospital | $1,868 | — | — |
| Yakima Valley Memorial | $638 – $1,920 | — | — |
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
- $740 (fee)