Healthcare Insights
Top 25 most common prosthetics by claims volume
By the end of 2023, more than 5.6 million people in the U.S. were living with limb loss. 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 peripheral vascular disease (often associated with diabetes) and trauma.
Many people living with the loss of a body part choose to wear prosthetics to support functionality in daily life or for aesthetic purposes. However, many other prosthetics are designed to support people recovering from injury or living without a body part.
Using data from the Atlas All-Payor Claims Dataset, we’ve compiled a list of the most common prosthetics by claims volume.
| Rank | HCPCS/CPT code | HCPCS/CPT description | % total procedures | Explore dataset |
|---|---|---|---|---|
| 1 | L3000 | Ft insert ucb berkeley shell | 10.00% | Explore |
| 2 | L3908 | Who cock-up nonmolde pre ots | 8.80% | Explore |
| 3 | L4361 | Pneuma/vac walk boot pre ots | 8.40% | Explore |
| 4 | L8699 | Prosthetic implant NOS | 5.90% | Explore |
| 5 | L1902 | Afo ankle gauntlet pre ots | 4.80% | Explore |
| 6 | L3260 | Ambulatory surgical boot eac | 3.20% | Explore |
| 7 | L3670 | So acro/clav can web pre ots | 2.90% | Explore |
| 8 | L3020 | Foot longitud/metatarsal sup | 2.70% | Explore |
| 9 | L1820 | Ko elas w/ condyle pads & jo | 2.50% | Explore |
| 10 | L4360 | Pneumat walking boot pre cst | 2.30% | Explore |
| 11 | L1830 | KO immob canvas long pre ots | 2.10% | Explore |
| 12 | L3809 | Whfo w/o joints pre ots | 2.10% | Explore |
| 13 | L1833 | Ko adj jnt pos r sup pre ots | 1.70% | Explore |
| 14 | L4350 | Ankle control ortho pre ots | 1.50% | Explore |
| 15 | L3913 | HFO w/o joints CF | 1.50% | Explore |
| 16 | L3808 | WHFO, rigid w/o joints | 1.40% | Explore |
| 17 | L1812 | Ko elastic w/joints pre ots | 1.40% | Explore |
| 18 | L3933 | FO w/o joints CF | 1.30% | Explore |
| 19 | L4387 | Non-pneum walk boot pre ots | 1.20% | Explore |
| 20 | L4397 | Static or dynami afo pre ots | 1.20% | Explore |
| 21 | L3924 | Hfo without joints pre ots | 1.20% | Explore |
| 22 | L3010 | Foot longitudinal arch suppo | 1.10% | Explore |
| 23 | L3906 | WHO w/o joints CF | 1.10% | Explore |
| 24 | L3807 | Whfo w/o joints pre cst | 1.00% | Explore |
| 25 | L0650 | Lso sc r ant/pos pnl pre ots | 0.90% | Explore |
Fig. 1 Data is from Definitive Healthcare’s Atlas All-Payor Claims database. Claims volumes are from the calendar year 2023 and represent procedures in the L5000-L9900 HCPCS range sourced from multiple clearinghouses. Procedure volumes were gathered from individual physicians across facility types. Accessed April 2024.
The most common types of prosthetics
The most common type of prosthesis in 2023 was a foot insert (HCPCS code L3000), accounting for 10% of prothesis-related procedures found in the Atlas Dataset. This type of foot insert is a custom-made orthotic device designed to support and correct abnormalities of the foot. It is created by taking a mold of the patient's foot and then using that mold to create a rigid shell that is inserted into the shoe.
In second place is HCPCS code L3908, which refers to an orthotic device designed to support a patient’s wrist and hand and prevent the fingers from bending too far back. This procedure represented 8.8% of prosthetic procedure claims in 2023.
HCPCS code L4361 takes third place with 8.4% of procedures. This code refers to a standard, off-the-shelf walking boot used to protect and support a patient’s foot and ankle following surgery. These boots are commonly used to treat conditions like ankle sprains, stress fractures, bunions, and more.
Overall, the top 25 prosthetic codes fall into four categories: (1) devices designed to support the foot and ankle; (2) devices designed to support the wrist, hand, and fingers; (3) devices to assist patients with walking; and (4) a general category for the remaining codes that didn’t match anywhere else, such as HCPCS code L3670 and L0650, which refer to supports for the shoulder and spine respectively.
What is the most common transtibial prosthesis?
Transtibial prosthetics replace a patient’s limb below the knee, allowing them to retain the use of their joint. A body-powered prosthetic is generally considered the most common type of transtibial prosthesis. These devices are comprised of a socket to fit around the residual limb, a pylon that connects the socket to the foot, and a prosthetic foot.
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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