HCPCS S1040

Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)

Current code13 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS S1040 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$2,100$5,250
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$2,100$5,250
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01———
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$2,100$5,250
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$2,100$5,250
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$2,100$5,250
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$2,100$5,250
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$2,100$5,250
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
Seattle Children's HospitalSeattle$1,393 – $1,76212 plans$5,420$5,420
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$2,100$5,250
Virginia Mason Medical CenterSeattle———
Yakima Valley MemorialYakimaFile dated 2026-08-27—$1,680$4,200

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

CMS publishes no national amount for this code.