HCPCS L5655
Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
Current codeBelow Knee Orthotic24 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $217 | $542 |
| Deaconess Medical Center | — | $217 | $542 |
| Harborview Medical Center | — | $517 – $521 | $738 – $744 |
| Mary Bridge Children's Hospital | — | $217 | $542 |
| MultiCare Auburn Medical Center | — | $217 | $542 |
| MultiCare Covington Medical Center | — | $217 | $542 |
| MultiCare Good Samaritan Hospital | — | $217 | $542 |
| MultiCare Valley Hospital | — | $217 | $542 |
| Seattle Children's Hospital | $333 – $509 | $1,323 – $2,018 | $1,323 – $2,018 |
| Tacoma General Allenmore Hospital | — | $217 | $542 |
| University of Washington Medical Ctr | — | $655 | $936 |
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
- $425 (fee)