Healthcare Insights

Top 25 Most Common Prosthetics by Claims Volume

In 2019, nearly 160,000 claims for limb amputation were submitted, according to Definitive Healthcare data. For many amputees, prosthetic limbs offer improved mobility and independence.

More than 2.1 million people in the U.S. were living with limb loss in 2019. This number is expected to double by 2050, which indicates many new opportunities for prosthetic developers and specialists. Limb loss may occur through a congenital defect, accident, traumatic injury, or illness. The main illness-related causes of limb loss are vascular diseases, such as diabetes.

Below, we've compiled a list of the most common prosthetics by total claims volume.

25 Most common prosthetics by claims volume, 2019

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RankHCPCS CodeDescriptionEst. Number of ProceduresChargesExplore This Dataset
1.L8699Prosthetic implant not otherwise specified187,997$2,237,168,593Explore This Profile
2.L8000Mastectomy bra22,650$9,174,809Explore This Profile
3.L8030Breast prosthesis w/o adhesive21,900$13,417,763Explore This Profile
4.L8600Implant breast, silicone or equal18,389$159,271,025Explore This Profile
5.L8613Ossicula implant10,632$27,701,213Explore This Profile
6.L8614Cochlear device10,520$855,049,352Explore This Profile
7.L8509Tracheo-esophageal voice prosthesis, inserted by a health care provider, any type9,565$8,451,654Explore This Profile
8.L8610Ocular implant9,209$13,538,959Explore This Profile
9.L8612Aqueous shunt prosthesis7,203$33,602,387Explore This Profile
10.L8606Synthetic implant, urinary, 1ml7,169$27,610,811Explore This Profile
11.L8020Mastectomy form4,066$1,758,585Explore This Profile
12.L8690Auditory osseointegrated device, includes all components3,890$119,266,685Explore This Profile
13.L8642Hallux implant2,731$22,819,679Explore This Profile
14.L9900Orthotic & prosthetic supply/accessory/service2,259$3,007,284Explore This Profile
15.L8689External recharging system for battery (internal) for use with implantable neurostimulator, replacement only2,183$11,200,328Explore This Profile
16.L8015External breast prosthesis garment1,662$287,738Explore This Profile
17.L8630Metacarpophalangeal implant1,450$5,212,581Explore This Profile
18.L8670Vascular graft, synthetic1,374$4,300,584Explore This Profile
19.L8641Metatarsal joint implant1,366$10,063,368Explore This Profile
20.L8604Dextranomer/hyaluronic acid1,322$13,809,490Explore This Profile
21.L8681Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only1,295$6,487,131Explore This Profile
22.L8603Collagen implant, urinary, 2.5 ml1,157$5,620,844Explore This Profile
23.L8420Prosthetic sock, multi ply, below knee926$261,695Explore This Profile
24.L8515Gelatin capsule, application device for use with tracheoesophageal voice prosthesis896$172,484Explore This Profile
25.L5673Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism890$2,569,374Explore This Profile

Fig 1. Data is from Definitive Healthcare's Medical Claims database. Claims volumes are from calendar year 2019, and are sourced through multiple clearinghouses. Procedure volumes were gathered from individual physicians across facility type. Accessed Sept. 2020.

Ossicular and cochlear implants are two of the most widely implemented prosthetics. Both are ear implants that aim to restore full or partial hearing. Several prosthetic accessories, including chargers and programmers, also made the list.

Outside of these, many of the most commonly used prosthetics fall into two categories:

1. Breast Prostheses

Of the top 25 most commonly implanted prosthetics in 2019, over 68,600 were breast prostheses.

The number of women choosing to have mastectomies is holding steady in the United States. Using claims data, Definitive Healthcare tracked over 183,000 mastectomies in 2019. There were 213,000 procedures in 2018 and 169,000 in 2017.

Many women who choose mastectomies hope to avoid radiation treatments, biopsies, and mammograms. Following a mastectomy, some women choose breast reconstruction.

If a patient decides that breast reconstruction isn’t for them, a prosthesis or breast form can help them look balanced without surgery. Breast prostheses come in a variety of shapes, sizes, and materials. Common prosthetic fillings include silicone gel, foam, and fiberfill.

Foam and fiberfill are lightweight options, while silicone is a more realistic option. Silicone prostheses were the most common in 2019, with over 18,000 implementations.

2. Leg prostheses

“Below the knee" prosthetic parts and sockets saw some of the highest claim volumes. This includes accessories like “prosthetic socks,” with over 900 implementations in 2019. Below-the-knee, or transtibial, prosthetics attach to the upper leg, just below the knee. They are fit with a socket, which is carefully molded around a plaster cast taken from the residual limb.

Sockets and accessories make up a large portion of the prosthetics market. This may be because a patient's residual limb is likely to change shape and size over time, so new sockets are needed as the patient ages. This explains the high volume of HCPCS code L5673, which covers additions to existing leg implants.

Above knee, or transfemoral, prosthetics are for patients who have had all or part of their upper legs amputated. Whether a leg prosthesis is “right” for a patient depends on several factors. Some of which include:

  • The amount of soft tissue covering the femur
  • If the patient feels significant pain in this area
  • The condition of the skin on the residual limb
  • Range of motion for the residual limb
  • Patient activity level before the amputation

Above the knee prosthetics can be more difficult to use than below the knee prosthetics. An intact knee joint makes movement easier for a patient, meaning less time is needed to adjust to a prosthetic.

Who uses prosthetic data?

There are many reasons to leverage data on amputations and prosthetics. Medical device companies can use this information to assess the competitive market and identify displacement opportunities. These companies can search all prosthetic types to find market gaps. They can also identify where competing devices are being used and avoid those regions—or craft specialized value propositions.

Healthcare staffing firms can also use prosthetics data. If a firm needs to place a surgeon, they can find the facilities performing the highest amputation volumes. Additionally, if a candidate has experience with specific prosthetic types, a firm can analyze outcomes at facilities using those devices. Then they can identify facilities that would most benefit from a surgical specialist.

Explore our data