HCPCS L5654 at Seattle Children's Hospital

Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)

Seattle Children's Hospital, Seattle

Description from CMS's HCPCS Level II code file.

What Seattle Children's Hospital publishes for this code: as an outpatient

Seattle Children's Hospital’s prices for HCPCS L5654, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$921 – $1,63798 plans	—
Medicaid managed careInsurer rates	$438 – $55412 plans	—
Medicaid (state program)Insurer rates	$4301 plan	—
Other government programInsurer rates	$6991 plan	—
UnknownInsurer rates	$430 – $1,5355 plans	—
Cash pricePaying yourself, without insurance	$1,706	—
List priceBefore any discount; few people pay it	$1,706	—

Lowest and highest amounts Seattle Children's Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in Seattle (King County) for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS L5654 at Seattle Children's Hospital
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS L5654 at every Washington hospital, with Medicare’s reference amounts.