HCPCS V2628
Fabrication and fitting of ocular conformer
Current code21 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 | $487 – $535 | — | — |
| Deaconess Medical Center | $487 – $535 | — | — |
| Kadlec Regional Medical Center | $497 – $596 | — | — |
| Mary Bridge Children's Hospital | $487 – $535 | — | — |
| MultiCare Auburn Medical Center | $487 – $535 | — | — |
| MultiCare Covington Medical Center | $487 – $535 | — | — |
| MultiCare Good Samaritan Hospital | $487 – $535 | — | — |
| MultiCare Valley Hospital | $501 – $535 | — | — |
| Overlake Hospital Medical Center & Clinics | $497 – $517 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $497 – $596 | — | — |
| Providence Centralia Hospital | $497 – $795 | — | — |
| Providence Regional Medical Center Everett | $497 – $546 | — | — |
| Providence St Peter Hospital | $497 – $795 | — | — |
| Swedish Edmonds Hospital | $497 – $596 | — | — |
| Swedish Issaquah | $497 – $596 | — | — |
| Swedish Medical Center | $497 – $596 | — | — |
| Swedish Medical Center / Cherry Hill | $497 – $596 | — | — |
| Tacoma General Allenmore Hospital | $487 – $535 | — | — |
| Virginia Mason Medical Center | $341 – $511 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $487 – $545 | — | — |
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
- $497 (fee)