HCPCS L5654
Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)
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 | $465 – $511 | — | — |
| Deaconess Medical Center | $465 – $511 | — | — |
| Harborview Medical Center | $474 – $522 | $581 | $830 |
| Kadlec Regional Medical Center | $474 – $569 | — | — |
| Mary Bridge Children's Hospital | $465 – $511 | — | — |
| MultiCare Auburn Medical Center | $465 – $511 | — | — |
| MultiCare Covington Medical Center | $465 – $511 | — | — |
| MultiCare Good Samaritan Hospital | $465 – $511 | — | — |
| MultiCare Valley Hospital | $479 – $511 | — | — |
| Overlake Hospital Medical Center & Clinics | $474 – $493 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $474 – $569 | — | — |
| Providence Centralia Hospital | $474 – $759 | — | — |
| Providence Regional Medical Center Everett | $474 – $522 | — | — |
| Providence St Peter Hospital | $474 – $759 | — | — |
| Seattle Children's Hospital | — | $1,706 | $1,706 |
| Swedish Edmonds Hospital | $474 – $569 | — | — |
| Swedish Issaquah | $474 – $569 | — | — |
| Swedish Medical Center | $474 – $569 | — | — |
| Swedish Medical Center / Cherry Hill | $474 – $569 | — | — |
| Tacoma General Allenmore Hospital | $465 – $511 | — | — |
| University of Washington Medical Ctr | $474 – $522 | $812 | $1,161 |
| Virginia Mason Medical Center | $326 – $488 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $465 – $521 | — | — |
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
- $474 (fee)