HCPCS L5673
Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism
Current codeBelow Knee Orthotic24 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $447 | $1,118 |
| Deaconess Medical Center | — | $447 | $1,118 |
| Harborview Medical Center | — | $1,062 – $1,074 | $1,517 – $1,535 |
| Mary Bridge Children's Hospital | — | $447 | $1,118 |
| MultiCare Auburn Medical Center | — | $447 | $1,118 |
| MultiCare Covington Medical Center | — | $447 | $1,118 |
| MultiCare Good Samaritan Hospital | — | $447 | $1,118 |
| MultiCare Valley Hospital | — | $447 | $1,118 |
| Seattle Children's Hospital | $555 – $1,405 | $2,158 – $4,321 | $2,158 – $4,321 |
| Swedish Edmonds Hospital | — | $1,067 | $2,222 |
| Swedish Issaquah | — | $1,067 – $1,164 | $2,222 – $2,424 |
| Swedish Medical Center | — | $1,164 – $1,253 | $2,424 – $2,610 |
| Swedish Medical Center / Cherry Hill | — | $1,067 – $1,164 | $2,222 – $2,424 |
| Tacoma General Allenmore Hospital | — | $447 | $1,118 |
| University of Washington Medical Ctr | — | $1,412 | $2,017 |
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
- $877 (fee)