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HCPCS L5681

Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)

Current codeBelow Knee Orthotic23 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$806$2,015
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$806$2,015
Harborview Medical CenterSeattleFile dated 2026-04-01—$1,906 – $1,937$2,723 – $2,767
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$806$2,015
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$806$2,015
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$806$2,015
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$806$2,015
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$806$2,015
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$806$2,015

Lowest and highest amounts each hospital lists for this code during a hospital stay, 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
$1,581 (fee)