Over the years, we have provided prosthetic service to many people all over Illinois at their residences, nursing homes, assisted living faclities and in the hospital. The question of pricing does comes up for prosthetics fairly often and our goal here is to help give you the answer you are looking for. If you have read our other information, you know that transparency is our goal and we would like to help you find the answers you are looking for in all areas prosthetics & orthotics. This article describes about cost price of Below Knee Prosthetic Leg With Suction.
The price for a below knee prosthetic leg with suction suspension can range from $5919.00 to $ 16,675.00 approximately.
This article will be cover these costs, but as you can see it must be presented, especially at first, in a range.
We didgave this rangeto try andinform you about the real world of prosthetics.
If we gave you one price, we would be misleading you and that is not our intention. If you just wanted a simple range of costs, then great. There they are thereabove us, but if you want to understand your prices more specifically, then take the $5919 and plug in the foot codes we willtalk about shortly. Again, we realize there are variances, but we are trying to give you a good ball park cost here with a good amount of supporting information.
Having said this, we will soon show you how you can get close on the cost that will be yours, based off not only the foot but also what your K Level is. (More on K Levels shortly.)
Please note that these are ONLY the costs, if you were paying in cash. Your insurance or other coverage can pick up 80-100% of the cost, if all documentation, medical necessity and deductibles are met in many instances. So, as you can see there is another layer to this equation, which can help you negate the dollar amounts you see above.
In the world of prosthetics you will find that price varies a lot on quantity of the items you receive and the sophistication of the componentry you are given.
If you are new to prosthetics, you might be wondering what componentry is.
Left below knee prosthetic leg with suction suspension and sleeve
Componentry
“Componentry” is the term used to describe the parts of the prosthesis that come together to form a complete system.
You already know that just like with other purchases you have made in the past that there is standard version and then there are premium versions of goods sold.
The needs of the user matter and sometimes a person might only need a basic system while others need a lot more sophistication of movement or range of motion that will require higher end componentry.
L Codes
Moreover,many parts of the prosthesis have a certain L code attached to it. And, each L code has a dollar sign attached to it. Please note that the price of each L codeis not set by the prosthetist. Coverages (such as insurance, etc) tell a prosthetist what an L code reimburses at, not the other way around. Meaning, the pricing structure is not founded by the person giving you the prosthetic leg. This is good because it holds the pricing to a more uniform spectrum of costs and a greedy salesman can not skyrocket the price on you out of the blue. It is regulated.
We will provide a list of L codes below that we believe are common for a suction type, below knee (bk)prosthesis.
Quantities
We also give common quantities for a certain number of those L codes provided.
For example, sometimes people are given two gel liners and this is done to help with hygiene and longevity of the liner (For example, if you got two gel liners you can switch them out routinely).
As far as quantities go, after having read this, you can now opt for a quantity of one, in the situations where 2 are offered and your price could go down, for example. This is not always recommended from a treatment standpoint, but when it comes to a cash analysis, you could reduce some quantities to get closer to the price you require.
We think you get the general point.
Not all amputees get a suction system either, but we are presenting this for those of you who are interested in learning more about these costs. If you want to learn more about below knee prosthetic leg costs for a pin type suspensionsystem, you are welcome to read our other article located under the pricing tab.Pin locking systems for below knee amputees are inthe same realm of the costs mentioned here, but there are a few key differences.
The Prosthetic Foot
A large part of the price of a prothesis is the foot. An expensive high end foot can really change the range of cost by $7929.00, for example. Just taking that number (7929) right off of the top of the high end priceand replacing it with a $394.00 foot can really change the equation for you. For example, someone who walks up and down curbs but doesn’t walk very fast or far, is a K2 ambulator (walker)typically. K2 ambulators typicallydo not require the K3 or K4 foot that costs $7929.00. Does the K3 or K4 foot move a lot more fluidly? Absolutely. But if we are trying to minimize costs andjust wantto get from A to B, then maybe the $394.00 foot isn’t so bad after all.
*Please note we will get into what a K Level is shortly, but for now, just know that a “K2” in generalis more basicthan a “K4” is. The K4 ambulator (walker)usuallyis someone who can walk slow, fast and run. Both are amputees, but their functional levels are different.
Prices for Prosthetic Feet With The Different K Levels
K1 feet, as you can already see are very basic. Not bad, just basic in design. The price is minimal and is often
The picture above depicts a below knee prosthesis that incorporates a sleeve to aid in suction suspension.
incorporated into the L5301 hcpc code that you will soon see below.
The next level of feet are for aK2 ambulator. This foot can itself vary in cost, but it still remains on the lower end of the spectrum. With one very common distributor, we have seen that the codes for K2 feet can lead us to a price of $394.00 on up to $1166.00, for example.
The next level above K2, as you probably already figured out is K3. A K3 foot has more range of motion and sophistication of movement. Within this foot type, there are many prices that can be seen. The range basically has aprice withinevery thousand dollar mark from $2,000.00 up to nearly $8,000.00. Prices that are seen within this K level are : $2480, $3395, $4167, $5971, $7010, $7929. – We rounded to the nearest dollar for simplicity.
Lastly, there is a group of K4 feet. These feet are typically reserved for athletes. People who exhibit high impact tendencies such as hiking or running for example and are more apt to use the premium feet, lest they break the K3 versions due to over stressing the K3 or K2 range of motion repeatedly. These feet can vary in price, but some of the prices we have seen for K4 feet are : $3318, $4151, $7929, all within the same K4 family.
Check out our other article on prosthetic feet if you want to take a closer look at everything related to prosthetic feet.
Cash Prices & How Insurance & Other CoveragesCan Assist
The prices mentioned above are cash prices. But we all know that medical coverage, like insurance for example can assist with reducing your out of pocket expenses. This is nothing new. Having said that, it is very possible that your costs can be reduced by 80-100 percent given the amount of coverage you have. Also, your deductible for these insurance plans, for example will come into play as well.
Please remember that the costs of the feet above are some common prices you will find, there are other prices that exist and this will be more clarified in other articles we write. There are more than 270 prosthetic feet on the market and prosthetic feet deserve a full article unto themselves in terms of pricing. We did try to give you some common prices though so you have a general feel on costs.
Other Cost Factors For A Prosthetic Leg, Beyond The Foot
Are you aware of what your K Level is?
At a glance, your “K Level” is how well you can move around independently.
A K level like wekeep referring to directly relates to your ability to walk certain distances and perform certain activities of daily living. Not everyone is a runner for example. Not everyone goes on long walks at fast speeds even. Some folks walk on level surfaces and get the mail. Some people stay inside mostly. It all varies.
You can see the way in which price can go up and down now probably.
K Levels In Much More Detail
K zero :
This level of functionality is minimal. Many of these amputees might now want to walk or can not do so due to physical challenges.
K 1 Level :
An individual who walks on level surfaces. This individual is most likely in their residence often times. The foot that is directly related to a K1 ambulatory (walker) is a SACH foot. SACH stands for : Solid Ankle Cushioned Heel. In essence it is a very basic foot. K1 walkers most likely consider the use of a cane or walker for example.
K 2 Level :
Someone who can walk slightly more than a k1 ambulator. They can step up and down curbs generally. But the
This patient just went up a stair, so at first appearance they are at least a K2 ambulator.
ambulation is still very simplified. The cadence is at a fixed speed. As shown above in the sections about general foot costs you can guess (without even knowing a lot about K Levels) that the price can vary from $394- $7929.
K3 Level :
A person who has reached a level of K3 can obviously do more than a K2 ambulator. The big difference is the speed at which they can walk. Basically they can walk fast and slow and can walk greater distances than a K2 ambulator typically. A K3 walker is someone who is referred to as a “community ambulator” and can do more slopes, inclines and declines as compared to a curb as mentioned above in K2.
K4 Level :
someone who can be extremely active. Usually, this level of amputee is someone who can perform in sports. Think athlete when you think of a K4 amputee. They don’t have to be an Olympic athlete, but someone who really is another step above a K3 functional level.
The levels indicated above are not always where the amputee might be a particular moment in time. K levels have a lot to do with potential and where a person will be in the near future. If you are amputee reading this make sure to discuss your abilities directly before an amputation with your doctor and prosthetist. Documentation of this information is animportant partin verifying someone’s k level.
Looking At Price Beyond The Foot
The following is a list of L codes that pertains to a suction style prosthesis. We came to these prices by taking two well known coverages and averaging them. Their prices are often times very similar so the numbers are not skewed, per se. We rounded prices up the next highest dollar if the cents mark was at 50 cents or higher.
L5301 : $2635.00
L5620 (x2) : $292 x 2 = $584
L5629 : $311.00
L5637 : $377.00
L5647 : $ 698.00
L5685 x2 :$113.00 each x 2 = $226.00
L5679 : $578.00
L5910 : $354.00
L5940 : $491.00
Textiles:
L8420 (x2) $19 x 2 =38.00
L8440 (x6) $45.00 x 6 = $270.00
L8470 (x6) 6.00 x 6 = $36.00
Addition of a flexible inner liner – L5645 : $958.00
With Addition of a custom protective cover – L5704 : $615.00
And Addition of a protective skin – L5962 : $575.00
Again, please keep in mind that the price we are sharing will be affected depending on your insurance or other coverage (if any). There are many different insurance plans and sub-plans, available to patients, therefore it can be difficult to determine exactly how much you will pay out-of-pocket without first contacting your insurance and knowing exactly the kind of prosthesis you will be getting from your prosthetist.
Some insurance plans may cover up to 80% – 100% of the leg; other plans may come with higher deductibles, which may lead to larger costs for you up-front before your coverage begins. It is best to contact your individual insurance plan for more information. But now you know the common L codes that you could possiblyrun into. As a result, you will be more equipped to get the answers you are looking for. Especiallyif you go directly to the insurance company and not have the prosthetic company help you get the quote of benefits of your plan.
The best price range we can offer for the prosthetic leg as mentioned is $5919.00 to $ 16,675.00. (We will discuss elevated vacuum in another article.) This is our attempt, based on previous data, to give you the best information possible to make your decision. The range varies based on two main factors
1) higher costs based on prosthetic add-on features and
2) reimbursement levels, which vary across states and from year to year. Most people do not pay cash for a prosthetic leg. However, if you do choose cash, this range provides you with a way to prepare financially for upcoming costs.
To help you decrease your costs, especially if you are paying with cash, one solution would be to ask your prosthetist to do one test socket.
Another solution may be to ask your prosthetist to provide only one gel liner (though most people opt for two gel liners for hygiene’s sake and for preservation).Though these are not in line with best practices and could affect your overall treatment, these may be a cost-effective compromise to get you closer to the lower range of $5919.00.
If you lack insurance, Medicare, or Medicaid, you could also contact your prosthetist for an alternative payment program. For those with insurance, there are no compromises on price. It is frowned upon to alternate between charging people cash for a discount and charging insurance at other times.
We hope this article has been some help to you in determining a price for a prosthesis that you may be seeking. We wanted to get you close to the price and illustrate why the price may vary.
Good luck!
*Rinella can not be liable for the prices you may encounter at other facilities. They may use more or less L codes and quantities that we can not control. We hope you understand that this will make the price change and without seeing you ourselves, we have no say in how it is priced out.
FAQs
How much does a below the knee prosthetic leg cost? ›
The cost of a prosthetic leg below the knee ranges from $3,000 to $24,000. Prices are determined according to the brand of the selected prosthesis, the characteristics of the selected carbon foot and the characteristics of the selected silicone liner.
What is the difference between pin and suction prosthetic? ›Both systems use gel liners within undersized total surface-bearing sockets, although their modes of suspension are quite different. Pin suspension uses a metal pin extending distally from the liner that locks into a receptacle at the bottom of the socket. Suction suspension does not use a pin.
How does a suction prosthetic leg work? ›Suction. A suction suspension system implements a soft liner in conjunction with a one-way expulsion valve and suspension sleeve. The liner goes over the residual limb before placing it into the socket. As you apply weight, the valve releases air to keep your limb firm inside the prosthetic.
What are the best prosthesis for a below knee? ›- The Preparatory Prosthesis.
- The Patella-Tendon Weight-bearing Prosthesis (PTB)
- Total-Surface Bearing Prosthesis.
- A Joint-Corset Prosthesis.
Original Medicare typically pays 80 percent of all approved costs for prosthetic devices, including artificial eyes and limbs. Your prosthetic device must be considered medically necessary to receive Medicare coverage. You may need to get prior authorization before Medicare pays your claim.
Does a prosthetic leg count as a disability? ›If you have a prosthetic limb that allows you to walk effectively, your application for Social Security disability benefits may be denied. However, you may be eligible for benefits if you can prove that even with a prosthetic limb: You are limited in the amount of time that you can stand or walk.
Is vacuum the same as suction suspension? ›The vacuum pump prevents your residual limb from significantly changing size during the day and the continuous vacuum aids in circulating fluid in and out of your residual limb at a constant rate. Whereas suction suspension allows fluid to leave your residual limb, but does not influence fluid to return like vacuum.
What are the benefits of vacuum suspension? ›The purported benefits of vacuum suspension systems include, but are not limited to: improved suspension (reduction in the amount of pistoning), maintenance of limb volume throughout the day, and increased tissue oxygenation to the residual limb.
What is meant by suction suspension? ›Suction suspension is created with direct contact between the liner (or with the membranes on the liner) and the socket wall. With this system a mechanism/pump sucks the air out between the liner and the socket creating a negative pressure that is the same across the entire surface.
How hard is it to walk with a below knee prosthetic? ›It's generally easier to use a below-the-knee prosthetic leg than an above-the-knee prosthesis. “If the knee joint is intact, the prosthetic leg takes much less effort to move and allows for more mobility,” explains Keszler.
How long does it take to walk with a prosthetic leg? ›
Most people can learn how to use a prosthetic leg within five months after the surgery. This is only an average, however; some may take longer than that. You'll get faster and more confident with practice. If you feel discouraged, don't stop practicing—you will get better!
Can you drive with below knee prosthetic? ›If you have double below knee amputations you may choose to drive with hand controls and/or request to be tested using your prosthesis. In some cases people with both a below and/or above right knee amputation can request to be tested to drive an unmodified car.
What are the three most common types of prosthetics is used? ›There are usually four main types to consider: transradial, transfemoral, transtibial, and transhumeral.
How does a vacuum prosthetic work? ›An elevated vacuum system attaches to a prosthesis and draws a vacuum at the distal end of the socket. Particularly during swing phase, the vacuum pulls residual limb soft tissues outward, thereby lowering pressure within the interstitial fluid inside the residual limb.
What is the difference between suction and vacuum pump? ›Vacuum is the total absence of air whereas suction is the process done to achieve a vacuum. Edit 1: Suction in a vacuum cleaner creates the vacuum. The surrounding air rushes to fill that vacuum created, thereby taking all the dirt particles with it. The air gushes very forcefully.
How can I get a free prosthetic leg? ›Amputee Blade Runners is a nonprofit organization that helps provide free running prosthetics for amputees. Running prosthetics are not covered by insurance and are considered “not medically necessary,” so this organization helps amputees keep an active lifestyle.
How long do you wear a stump shrinker? ›Wear your bandage or shrinker all the time, except when you are washing your leg or checking the skin. During the day, take your bandage or shrinker off every 3 to 4 hours for 15 minutes. Use this time to check your skin for signs of pressure. You can also massage your leg at this time.
How much is a high quality prosthetic leg? ›The cost of a prosthetic leg depends on two primary factors, including the type of prosthetic and how much the patient's insurance covers. More basic prosthetics can cost around $5,000, while more advanced, computerized prosthetic legs may reach $70,000.
Can you drive a car with a prosthetic leg? ›People with all levels of limb loss or limb difference can still drive a car. Depending on the level or type of limb loss or limb difference as well as your use or non-use of a prosthesis, you may need to choose an automatic transmission.
How many hours a day can you wear a prosthetic leg? ›If you are a new amputee, your shrinker should be worn 23 hours a day, except when you are bathing or washing the residual limb. If you have been an amputee and now have a prosthesis, you should wear your shrinker only while sleeping at night.
Can you get insurance on a prosthetic leg? ›
According to the Affordable Care Act (ACA), small group insurance plans cover the Essential Health Benefits, and this includes prosthetics. Even if you work for a large corporation, you might find that their insurance plan offers coverage for prosthetic limbs.
What is considered a strong suction vacuum? ›Most vacuums have suction power between 1000 Pa and 2000 Pa, but some more powerful suction vacuum can reach over 3,000 Pa.
Does a vacuum float better? ›If you could somehow fill a 1-liter bottle with a vacuum, it would float even better. A perfect vacuum weighs zero grams, so a liter of perfect vacuum weighs 0.18 grams less than a liter of helium.
What are the advantages and disadvantages of vacuum sealing? ›| Advantages of Vacuum Packing | Disadvantages of Vacuum Packing |
|---|---|
| Minimal Need For Chemical Preserves | Additional Sealer Attachments may be Required Based on Each Product |
| Quick and Efficient | Additional Labeling Often Needed |
| Reduced Product Loss | Basic Vacuum Bags can be Difficult to Open |
Vacuum generation units collect wastewater and condensate water by vacuum pumping it into a sewage treatment plant or collection tank. The latter are used to collect black water, which is waste from toilets and urinals, and gray water, which is waste from sources like washbasins, sinks, and showers.
What is the purpose of a vacuum system? ›Vacuum systems can handle debris, viscous oils, and the intake of air or water.
What is a suction lift condition? ›A suction lift simply means the maximum level of the liquid to be pumped is physically below the centerline of the pump impeller. Most centrifugal pumps can operate with a suction lift if they are primed first.
What does suction height mean? ›the suction head in a pumping system is the vertical dimension measured between the surface of the suction tank and the axis of the pump. This height is directly related to the hydrostatic load. This suction height plays a key role in the power of the pump and can not exceed a certain height (due to cavitation).
What is suction action? ›Suctioning is performed when the patient is unable to effectively move secretions from the respiratory tract. This may occur with excessive production of secretions or ineffective clearance, which leads to the accumulation of secretions in the upper and lower respiratory tract.
What are the disadvantages of a prosthetic leg? ›- Intact Limb Pain. ...
- Back Pain. ...
- Current Prosthetic Not Meeting Your Needs. ...
- Poor Balance, Instability, or a Fear of Falling. ...
- General Fatigue and Reduced Mobility. ...
- Irritation and Skin Issues. ...
- Socket Issues or Discomfort.
Can you walk up the stairs with a prosthetic leg? ›
Powered prostheses can enable individuals with above-knee amputations to ascend stairs step-over-step. To accomplish this task, available stair ascent controllers impose a pre-defined joint impedance behavior or follow a pre-programmed position trajectory.
Can you shower with a prosthetic leg? ›Due to their metal components, the prostheses that amputees wear every day cannot be carried with them to shower. So, some of them jump or crawl to the shower, while some of them even choose to reduce the frequency of their showers due to the hassle they bring.
Do people sleep with their prosthetic leg? ›It's Best to Leave Your Prosthetic Limb Off While Sleeping
A prosthesis is to help you achieve greater mobility. When you are trying to sleep, though, a prosthetic limb does not offer any benefit. It only gets in the way of sleeping comfortably.
Take off Your Prosthesis Limb
It is essential to take off a prosthetic limb before going to bed each night. Sleeping with a prosthesis on can cause injuries to the limb caused by awkward sleep positions or constant pressure on the limb from the prosthetic device.
Residual limb pain is when the area around your prosthesis hurts, due to limb shrinkage. This has an effect on how your prosthesis fits and can cause a prosthetic leg that once fit very well to start causing you pain and trouble.
Do prosthetic legs smell? ›Whether you're a recent amputee or have been one all your life, the problem of liner odor, well—it stinks. After the many adjustments and recalibrations you've likely endured when acclimating to a prosthetic device, the pungent odor that can accumulate between liner and skin can feel like insult added to injury.
Can you live a normal life with a prosthetic leg? ›Everything Is Possible
A healthy fitness routine and diet are more important than ever after an amputation. Muscle strength, coordination and a healthy weight make it easier to stay active. Just as it is with any skill, practice makes the use of the prosthetic easier and more natural.
A new amputee will need to wear the shrinker socks until the majority of the excess limb volume stabilizes. This process may take 2-4 weeks after application. After prosthetic fitting, the shrinker socks will be used to maintain volume and proper limb shape when you are not wearing your prosthesis.
Are prosthetic legs covered by Medicare? ›Prosthetic devices. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. covers prosthetic devices needed to replace a body part or function when a Medicare-enrolled doctor or other health care provider orders them.
How hard is it to learn to walk with a prosthetic leg? ›Walking on a prosthesis is more difficult than without one. It's hard to remember to pick up your foot and take a step. Even if your leg had been amputated below the knee, you'll need help at first from crutches or another person who can hold onto you for balance.
Can you wear a prosthetic leg all the time? ›
If you are a new amputee, your shrinker should be worn 23 hours a day, except when you are bathing or washing the residual limb. If you have been an amputee and now have a prosthesis, you should wear your shrinker only while sleeping at night.
Do you limp with a prosthetic leg? ›There are various phases of the average human gait that must be accounted for so that the amputee with a prosthesis can walk without much of a limp. One of the biggest problems in amputee walking is that the good limb is often weakened from disuse.
How long does it take to receive a prosthetic leg? ›How long does it take to get a prosthetic leg? The build and delivery time generally should take four weeks based on patient compliancy through the process.
How long do you wait for a prosthetic leg? ›Some individuals receive a temporary prosthesis immediately following amputation or within two to three weeks after surgery. Usually, a prosthetic device fitting begins two to six months after surgery once the surgical incision has healed completely, the swelling has gone down, and your physical condition improves.
How often will Medicare replace a prosthetic leg? ›How Often Does Medicare Pay For Prosthetic Legs? Medicare covers replacement prosthetics every five years. In addition, Medicare also covers polishing and resurfacing twice each year. Your benefits provide coverage for both long-term care as well as helping you maintain your devices.
How long is recovery for amputated leg? ›You will probably be able to return to work and your usual routine when your remaining limb heals. This can be as soon as 4 to 8 weeks after surgery, but it may take longer.