HCPCS L6890

Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment

Current code24 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.

Prices for HCPCS L6890 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$223 – $2456 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$223 – $2458 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$227 – $2505 plans$273 – $278$390 – $398
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$227 – $2737 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$223 – $2457 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$223 – $2457 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$223 – $2457 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$223 – $2457 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$229 – $2457 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$227 – $2363 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$227 – $2737 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$227 – $3647 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$227 – $2506 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$227 – $3647 plans——
Seattle Children's HospitalSeattle—$653$653
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$227 – $2738 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$227 – $2738 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$227 – $2738 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$227 – $2738 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$223 – $2457 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$227 – $2505 plans$352$503
Virginia Mason Medical CenterSeattle$156 – $2349 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27———
Yakima Valley MemorialYakimaFile dated 2026-08-27$223 – $2508 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
$227 (fee)