HCPCS L5638 HCPCS - DME
DMEPOS item L5638 Cost
Body System: General
Medicare Facility Rate
$794
CMS PFS CY2026
Medicare Non-Facility Rate
$794
Office/clinic setting
Frequently Asked Questions
How much does DMEPOS item L5638 cost?
The Medicare facility rate is $794. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does DMEPOS item L5638 cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $794.