HCPCS V5264

Ear mold/insert, not disposable, any type

Current code15 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 V5264 by hospital
Hospital	Commercial insurance rates (lowest – highest)	Cash price	List price (before discounts)
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$57.18 – $105	$81.68 – $150
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$62.40	$96.00
Seattle Children's HospitalSeattle	$68.47 – $22698 plans	$127 – $236	$127 – $236
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$67.94 – $80.59	$97.05 – $115
Virginia Mason Medical CenterSeattle	$48.04 – $76.004 plans	$38.25 – $48.45	$75.00 – $95.00

Lowest and highest amounts each hospital lists for this code during a hospital stay, 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.