HCPCS L7404
Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
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 | $655 – $720 | — | — |
| Deaconess Medical Center | $655 – $720 | — | — |
| Harborview Medical Center | $668 – $735 | $814 – $818 | $1,162 – $1,169 |
| Kadlec Regional Medical Center | $668 – $802 | — | — |
| Mary Bridge Children's Hospital | $655 – $720 | — | — |
| MultiCare Auburn Medical Center | $655 – $720 | — | — |
| MultiCare Covington Medical Center | $655 – $720 | — | — |
| MultiCare Good Samaritan Hospital | $655 – $720 | — | — |
| MultiCare Valley Hospital | $674 – $720 | — | — |
| Overlake Hospital Medical Center & Clinics | $668 – $695 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $668 – $802 | — | — |
| Providence Centralia Hospital | $668 – $1,069 | — | — |
| Providence Regional Medical Center Everett | $668 – $735 | — | — |
| Providence St Peter Hospital | $668 – $1,069 | — | — |
| Seattle Children's Hospital | — | $1,019 | $1,019 |
| Swedish Edmonds Hospital | $668 – $802 | — | — |
| Swedish Issaquah | $668 – $802 | — | — |
| Swedish Medical Center | $668 – $802 | — | — |
| Swedish Medical Center / Cherry Hill | $668 – $802 | — | — |
| Tacoma General Allenmore Hospital | $655 – $720 | — | — |
| University of Washington Medical Ctr | $668 – $735 | $1,034 | $1,477 |
| Virginia Mason Medical Center | $458 – $688 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $655 – $733 | — | — |
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
- $668 (fee)