HCPCS L5657
Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials
Current code10 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 | $300 – $330 | — | — |
| Deaconess Medical Center | $300 – $330 | — | — |
| Mary Bridge Children's Hospital | $300 – $330 | — | — |
| MultiCare Auburn Medical Center | $300 – $330 | — | — |
| MultiCare Covington Medical Center | $300 – $330 | — | — |
| MultiCare Good Samaritan Hospital | $300 – $330 | — | — |
| MultiCare Valley Hospital | $309 – $330 | — | — |
| Tacoma General Allenmore Hospital | $300 – $330 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $300 – $336 | — | — |
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
- $306 (fee)