HCPCS L7403

Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material

Current code24 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 L7403 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$381 – $2,95916 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$530 – $1,8429 plans——
Harborview Medical CenterSeattleFile dated 2026-04-01$708 – $8852 plans$534 – $542$762 – $775
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$667 – $1,2435 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$381 – $3,2487 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$371 – $1,91217 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$371 – $1,91217 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$430 – $1,91212 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$424 – $1,83810 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$406 – $1,21810 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$685 – $1,4689 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$748 – $1,6555 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$531 – $1,0277 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$376 – $1,4458 plans——
Seattle Children's HospitalSeattle$563 – $1,00198 plans$1,043$1,043
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$664 – $1,6247 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$664 – $9837 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$664 – $1,5819 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$664 – $1,5819 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$371 – $1,91217 plans——
University of Washington Medical CtrSeattleFile dated 2026-04-01$708 – $1,3885 plans$684$977
Virginia Mason Medical CenterSeattle$424 – $1,5397 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$1,1171 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$381 – $1,14813 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
$443 (fee)