HCPCS L5679

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, not for use with locking mechanism

Current codeBelow Knee Orthotic24 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS L5679 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$630 – $4,88619 plans$372$931
Deaconess Medical CenterSpokaneFile dated 2026-08-27$346 – $3,04116 plans$372$931
Harborview Medical CenterSeattleFile dated 2026-04-01$1,169 – $1,4622 plans$887 – $895$1,267 – $1,279
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$1,102 – $2,0535 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$601 – $5,36318 plans$372$931
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$612 – $3,15720 plans$372$931
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$612 – $3,15720 plans$372$931
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$612 – $3,15720 plans$372$931
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$346 – $3,03516 plans$372$931
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$670 – $2,01110 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$1,132 – $2,4249 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$1,235 – $2,7325 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$877 – $1,6957 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$621 – $2,3868 plans——
Seattle Children's HospitalSeattle$968 – $2,16898 plans$1,793 – $2,258$1,793 – $2,258
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$1,096 – $2,6817 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$1,096 – $1,6227 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$1,096 – $2,6109 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$1,096 – $2,6109 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$612 – $3,15720 plans$372$931
University of Washington Medical CtrSeattleFile dated 2026-04-01$1,169 – $2,2925 plans$1,130$1,615
Virginia Mason Medical CenterSeattle$700 – $2,5417 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$1,8441 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$630 – $1,89613 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

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
$731 (fee)