Prosthetic Foot Cost – Price Determination Factors

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Prosthetic feet can range in cost anywhere from $211.00 to $7929.00.

The cost of prosthetic foot must be presented in a range to you to start this article.   Why? –  This is due to the uniqueness of each patient and the prosthetic foot that best meets their needs.

We realize that you may have visited this article to get an exact price.  We can understand that. However, you will soon see that we are working in your best interests to start with this range and then get into more exact prices later in this article.

In addition, please note that the range of $211.00 – $7929.00 price estimation is what a prosthetic foot would cost, if someone is paying for the prosthetic in cash.

The good news is that most of the cost can be covered by your insurance or other coverage.  As much as 80 to 100 percent of the cost can be covered in many instances and your out of pocket costs could be minimal.

Does this happen every time?  – No

But it happens enough that you should have faith if you have medical coverage that this could be a possibility for you.  We say this because prosthetic feet, as you now know can get expensive, but your costs could be considerably less.

Certain things have to be in place to minimize your costs.  For example, proper documentation from the physician, nurse practitioner, or physician assistant and the prosthetist has to be there.  This can include the aforementioned clinician’s progress notes and a letter of medical necessity for example that is properly created.  (As a patient / consumer it is not really your job to get this all figured out, but we just wanted to let you know about the process.)

The documentation must be properly constructed in order to prove an individual’s needs to their insurance or Medicare, for example.  A person who can barely walk does not qualify for an Olympic grade running foot that is custom made, for example.

A Few Bad Apples…

Unfortunately, somewhere along the line, a few people were giving expensive feet to people who could barely walk, so as a result a whole system needed to be installed to regulate who can get what kind of foot and this really helped to correct the problem.

That is a logical conclusion and insurance and/or Medicare can not be blamed for this decision.

K Level Introduction & Other Variables

This article will help you get an estimated cost for a prosthetic foot. The estimate will be based on your K Level and a few other variables we will talk about.

This “K Level” is a 0-4 rating system used to indicate a person’s walking / running potential).  Just for introduction purposes, a K0 (K zero) is someone who is not mobile and a K4 is someone who is very active.  More on this later in the article

Componentry 

The price of a prosthetic foot is also largely dependent on the complexity of the componentry you require.  The complexity of the componentry will be directly related to your K level. A person who only needs a foot for basic purposes like walking around inside of their house needs a more basic model, compared to that of an extreme athlete.

If you are not familiar with the term “componentry”, it basically means the parts of the prosthesis that form a unified, working system.  If you consider most products or services we purchase in general, there are often multiple versions or tiers to choose from. For example, you can purchase an upgraded phone or the cheaper model that has fewer features.

With prosthetic feet it’s the same. Sometimes a person only needs/desires a basic system, while other people need/desire a more complex system that will allow for increased movement or range of motion. Complex systems require higher-end componentry, which costs more than the basic model.

HCPC Codes

In regards to componentry (parts of the prosthesis) another important thing to be aware of is that each part of the prosthesis will have a specific L code attached to it.  This includes a prothetic foot often times.

Every Lcode has a predetermined price associated with it that is not determined by the prosthetist.  These prices can actually vary from state to state and over time and you can see why we need to give you these costs in a range.  This is important for you to remember, so you will not feel like the prothetist is not pulling the price / cost out of thin air.

K1 : $211.00

K2 : $394.00, $1166.00

K3 : $2480.00, $3395.00, $4167.00, $5971.00, $7010.00, $7929.00

K4 : $3318.00, $4151.00, $7929.00

So the question now is, what K Level are you?

If you are someone who walks only on level surfaces at a fixed rate, then you are possible a K1 ambulator.  If you walk up and down curbs and can do some stairs, then you might be a K2 walker.  If you can walk further and can vary your speeds for that distance, then you might be a K3 ambulator.  Lastly, if you are an athlete then you could be entering the K4 level.

It all depends on what can be documented and what your potential is moving forward.

We hoped this information helped you.

Please check out our other articles on pricing for prosthetic legs, liners and other textiles in the prosthetic industry.

Please also remember that Rinella Prosthetics and Orthotics can not be responsible for any bills or differences in cost that you may encounter unless you are under treatment with our team.  We wanted to give you some good information and get you closer to what the price of a prosthetic foot may be but you can see that variables exist and we need to illustrate those variables with you to help provide a better understanding of the topic.

Best regards.