Healthcare Insights

Top 25 most common prosthetics by claims volume

More than 2.1 million people in the U.S. were living with limb loss in 2021. This number is expected to double by 2050, indicating new opportunities for prosthetic developers and specialists to help improve health outcomes for people living with an amputated limb. For many, a prosthetic limb offers improved mobility and a means to stay independent and active in one’s community.  

What is limb loss? 

Limb loss, or amputation, 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.  

By the end of 2021, more than 262,000 claims for limb amputation were submitted, according to Definitive Healthcare data from ClaimsMx.  

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

25 Most common prosthetics by claims volume, 2021

Rank HCPCS/CPT Code HCPCS/CPT Description # Total Procedures Total Charges Avg Charge/Procedure Explore Dataset
L8699 Prosthetic implant, not otherwise specified191,178 $643,896,514  $3,368  Explore
L8000 Mastectomy bra 8,495 $1,694,849  $200  Explore
L8680 Implantable neurostimulator electrode each 8,131 $130,117,549  $16,003  Explore
L8612 Aqueous shunt prosthesis 6,292 $17,530,621  $2,786  Explore
L8600 Implant breast silicone/eq 6,034 $33,243,667  $5,509  Explore
L8610 Ocular implant 4,741 $4,740,133  $1,000  Explore
L8606 Synthetic implant urinary 1ml 3,490 $9,092,328  $2,605  Explore
L8613 Ossicular implant 3,352 $3,327,822  $993  Explore
L8420 Prosthetic sock multiple ply below knee3,229 $561,798  $174  Explore
10 L8030 Breast prostheses w/o adhesive 2,957 $1,783,803  $603  Explore
11 L8614 Cochlear device 2,677 $208,664,499  $77,947  Explore
12 L8470 Prosthetic sock single ply below knee2,334 $135,774  $58  Explore
13 L8509 Tracheo-esophageal voice prosthesis2,188 $2,367,909  $1,082  Explore
14 L8687 Implantable neurostimulator pulse generator, dual array, rechargeable1,841 $76,764,921  $41,697  Explore
15 L8440 Shrinker below knee 1,747 $213,840  $122  Explore
16 L8689 External recharging system for battery (internal)935 $5,772,740  $6,174  Explore
17 L8690 Auditory osseointegrated device, includes all internal and external components934 $19,042,011  $20,388  Explore
18 L8400 Sheath below knee 885 $123,966  $140  Explore
19 L8015 External breast prosthesis garment 810 $155,136  $192  Explore
20 L8681 Patient programmer for use with implantable programmable neurostimulator 770 $2,104,132  $2,733  Explore
21 L8679 Implantable Neurostimulator, Pulse Generator, Any Type752 $26,051,531  $34,643  Explore
22 L8430 Prosthetic sock, multiple ply, above knee675 $145,207  $215  Explore
23 L8641 Metatarsal joint implant 633 $2,997,798  $4,736  Explore
24 L8688 Implantable neurostimulator pulse generator, dual array, non-rechargeable605 $24,725,259  $40,868  Explore
25 L8686 Implantable neurostimulator pulse generator, single array, non-rechargeable 563 $24,070,099  $42,753  Explore

Fig 1. Data is from Definitive Healthcare’s Medical Claims database. Claims volumes are from the calendar year 2021 and are sourced from multiple clearinghouses. Procedure volumes were gathered from individual physicians across facility types. Accessed Jan. 2022.  

The top two most common prosthetic categories 

It's evident that the most common prosthetics fall into two categories: 

Breast Prostheses 

Of the top 25 most common prosthetics in 2021, more than 18,000 breast implant and similar procedures were performed. This includes external breast prosthesis garment (L8015), breast prostheses w/o adhesive (L8030) and more.  
The number of women choosing to have mastectomies is holding steady in the United States. Using claims data, Definitive Healthcare tracked over 50,000 mastectomies in 2021. There were 51,000 procedures in 2020 and 53,000 in 2019. 
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 (L8600) were another common procedure in 2021, totaling 6,034 procedures.  

Leg Prostheses 

Below-the-knee prosthetic parts and sockets saw some of the highest claim volumes. This includes accessories like prosthetic socks (L8420 and L8470) with 3,229 and 2,334 procedures performed in 2021 respectively.  

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. 
Above knee, or transfemoral, prosthetics are for patients who have had all or part of their upper legs amputated. This includes HCPCS L8430, which is a prosthetic sock above knee prosthetic with 675 procedures performed in 2021. 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. 

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 

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. They can also identify where competing devices are being used and avoid those regions—or develop 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. 

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