HCPCS L6028 at MultiCare Good Samaritan Hospital

Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692

MultiCare Good Samaritan Hospital, Puyallup

Description from CMS's HCPCS Level II code file.

What MultiCare Good Samaritan Hospital publishes for this code: as an outpatient

MultiCare Good Samaritan Hospital’s prices for HCPCS L6028, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$3,780 – $4,4832 plans	—
Medicare AdvantageInsurer rates	$2,242 – $2,4667 plans	—
Cash pricePaying yourself, without insurance	—	—
List priceBefore any discount; few people pay it	—	—

Lowest and highest amounts MultiCare Good Samaritan Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-08-27. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS L6028 at MultiCare Good Samaritan Hospital
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS L6028 at every Washington hospital, with Medicare’s reference amounts.