HCPCS L5650

Additions to lower extremity, total contact, above knee or knee disarticulation socket

Current code24 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 L5650 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$605 – $4,69816 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$841 – $2,9249 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$1,124 – $1,4052 plans$852 – $861$1,216 – $1,230
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$1,060 – $1,9745 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$605 – $5,1577 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$589 – $3,03617 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$589 – $3,03617 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$683 – $3,03612 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$673 – $2,91810 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$644 – $1,93310 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$1,088 – $2,3319 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$1,187 – $2,6275 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$843 – $1,6307 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$597 – $2,2948 plans——
Seattle Children's HospitalSeattle$1,126 – $2,00298 plans$2,085$2,085
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$1,054 – $2,5777 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$1,054 – $1,5607 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$1,054 – $2,5109 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$1,054 – $2,5109 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$589 – $3,03617 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$1,124 – $2,2035 plans$1,206$1,722
Virginia Mason Medical CenterSeattle$673 – $2,4437 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$1,7731 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$605 – $1,82313 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
$703 (fee)