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.
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|Rank||HCPCS Code||Description||Est. Number of Procedures||Charges||Explore This Dataset|
|1.||L8699||Prosthetic implant not otherwise specified||187,997||$2,237,168,593||Explore This Profile|
|2.||L8000||Mastectomy bra||22,650||$9,174,809||Explore This Profile|
|3.||L8030||Breast prosthesis w/o adhesive||21,900||$13,417,763||Explore This Profile|
|4.||L8600||Implant breast, silicone or equal||18,389||$159,271,025||Explore This Profile|
|5.||L8613||Ossicula implant||10,632||$27,701,213||Explore This Profile|
|6.||L8614||Cochlear device||10,520||$855,049,352||Explore This Profile|
|7.||L8509||Tracheo-esophageal voice prosthesis, inserted by a health care provider, any type||9,565||$8,451,654||Explore This Profile|
|8.||L8610||Ocular implant||9,209||$13,538,959||Explore This Profile|
|9.||L8612||Aqueous shunt prosthesis||7,203||$33,602,387||Explore This Profile|
|10.||L8606||Synthetic implant, urinary, 1ml||7,169||$27,610,811||Explore This Profile|
|11.||L8020||Mastectomy form||4,066||$1,758,585||Explore This Profile|
|12.||L8690||Auditory osseointegrated device, includes all components||3,890||$119,266,685||Explore This Profile|
|13.||L8642||Hallux implant||2,731||$22,819,679||Explore This Profile|
|14.||L9900||Orthotic & prosthetic supply/accessory/service||2,259||$3,007,284||Explore This Profile|
|15.||L8689||External recharging system for battery (internal) for use with implantable neurostimulator, replacement only||2,183||$11,200,328||Explore This Profile|
|16.||L8015||External breast prosthesis garment||1,662||$287,738||Explore This Profile|
|17.||L8630||Metacarpophalangeal implant||1,450||$5,212,581||Explore This Profile|
|18.||L8670||Vascular graft, synthetic||1,374||$4,300,584||Explore This Profile|
|19.||L8641||Metatarsal joint implant||1,366||$10,063,368||Explore This Profile|
|20.||L8604||Dextranomer/hyaluronic acid||1,322||$13,809,490||Explore This Profile|
|21.||L8681||Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only||1,295||$6,487,131||Explore This Profile|
|22.||L8603||Collagen implant, urinary, 2.5 ml||1,157||$5,620,844||Explore This Profile|
|23.||L8420||Prosthetic sock, multi ply, below knee||926||$261,695||Explore This Profile|
|24.||L8515||Gelatin capsule, application device for use with tracheoesophageal voice prosthesis||896||$172,484||Explore This Profile|
|25.||L5673||Addition 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 mechanism||890||$2,569,374||Explore 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:
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.
“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:
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.
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.