HCPCS L5668
Addition to lower extremity, below knee, molded distal cushion
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 | — | $70.00 | $175 |
| Deaconess Medical Center | — | $70.00 | $175 |
| Harborview Medical Center | — | $166 – $168 | $238 – $240 |
| Mary Bridge Children's Hospital | — | $70.00 | $175 |
| MultiCare Auburn Medical Center | — | $70.00 | $175 |
| MultiCare Covington Medical Center | — | $70.00 | $175 |
| MultiCare Good Samaritan Hospital | — | $70.00 | $175 |
| MultiCare Valley Hospital | — | $70.00 | $175 |
| Seattle Children's Hospital | $110 | $437 | $437 |
| Tacoma General Allenmore Hospital | — | $70.00 | $175 |
| University of Washington Medical Ctr | — | $234 | $334 |
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
- $137 (fee)