HCPCS L6628
Upper extremity addition, quick disconnect hook adapter, otto bock or equal
Current code24 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $694 – $763 | — | — |
| Deaconess Medical Center | $694 – $763 | — | — |
| Harborview Medical Center | $708 – $779 | $867 | $1,239 |
| Kadlec Regional Medical Center | $708 – $850 | — | — |
| Mary Bridge Children's Hospital | $694 – $763 | — | — |
| MultiCare Auburn Medical Center | $694 – $763 | — | — |
| MultiCare Covington Medical Center | $694 – $763 | — | — |
| MultiCare Good Samaritan Hospital | $694 – $763 | — | — |
| MultiCare Valley Hospital | $715 – $763 | — | — |
| Overlake Hospital Medical Center & Clinics | $708 – $736 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $708 – $850 | — | — |
| Providence Centralia Hospital | $708 – $1,133 | — | — |
| Providence Regional Medical Center Everett | $708 – $779 | — | — |
| Providence St Peter Hospital | $708 – $1,133 | — | — |
| Seattle Children's Hospital | — | $1,996 | $1,996 |
| Swedish Edmonds Hospital | $708 – $850 | — | — |
| Swedish Issaquah | $708 – $850 | — | — |
| Swedish Medical Center | $708 – $850 | — | — |
| Swedish Medical Center / Cherry Hill | $708 – $850 | — | — |
| Tacoma General Allenmore Hospital | $694 – $763 | — | — |
| University of Washington Medical Ctr | $708 – $779 | $1,095 | $1,565 |
| Virginia Mason Medical Center | $486 – $729 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $694 – $777 | — | — |
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
- $708 (fee)