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Below knee, plastic socket, joints and thigh lacer, sach foot

HCPCS code

Name of the Procedure:

Below Knee Prosthesis with Plastic Socket, Joints, Thigh Lacer, and SACH Foot (L5105)


This procedure involves fitting a patient with a below-knee prosthetic limb. The prosthesis includes a plastic socket, mechanical joints, a thigh lacer (a strap to secure the prosthesis), and a SACH (Solid Ankle Cushion Heel) foot, which provides stability and a natural walking pattern.


The procedure addresses the need for limb replacement due to below-knee amputation. The goal is to restore mobility, increase independence, and improve the quality of life for individuals with limb loss.


  • Patients with below-knee amputations due to trauma, infection, or medical conditions such as diabetes.
  • Individuals seeking improved mobility and functionality.
  • Those who have healed sufficiently from the amputation surgery and do not have ongoing infection or severe edema (swelling).


  • No specific fasting or medication adjustments are generally required.
  • A precise mold of the residual limb is taken to create a custom-fit socket.
  • Pre-fitting assessments include checking the health of the residual limb and overall physical condition.

Procedure Description

  1. The custom plastic socket is fitted to the residual limb.
  2. Mechanical joints are aligned to match the natural knee motion.
  3. The thigh lacer is attached to ensure secure and comfortable fitting.
  4. The SACH foot is connected, providing a stable and cushioned walking base.
  5. Adjustments are made for optimal fit and alignment.
  6. Patient may be given instructions on how to wear and care for the prosthesis.


The fitting session typically takes 1-2 hours, but multiple visits may be required for adjustments.


This procedure is typically performed in a specialized prosthetics and orthotics clinic or outpatient facility.


  • Prosthetist
  • Prosthetic technicians
  • Occasionally, a physical therapist may be involved for gait training.

Risks and Complications

  • Skin irritation or pressure sores on the residual limb.
  • Alignment issues causing gait disturbances.
  • Loosening of the prosthesis.
  • Allergic reactions to materials used in the prosthesis.


  • Improved mobility and ability to perform daily activities.
  • Enhanced quality of life and independence.
  • Psychological benefits from regaining functionality.
  • Benefits can often be noticed immediately but may improve further with use and training.


  • Initial adaptation period to get used to the prosthesis.
  • Follow-up appointments for adjustments.
  • Regular maintenance and check-ups to ensure optimal performance.
  • Physical therapy may be recommended to improve gait and strength.


  • Other types of below-knee prostheses (e.g., dynamic-response feet, computerized knees).
  • Wheelchairs or other mobility aids.
  • Each alternative varies in cost, functionality, and suitability based on the patient's lifestyle and needs.

Patient Experience

  • Minimal discomfort during the fitting process.
  • Initial challenges adapting to the new prosthesis, which will be addressed through physical therapy and follow-ups.
  • Pain and discomfort management through proper fitting and adjustments.
  • Overall experience improves with time and use as the patient becomes more accustomed to the prosthesis.

Medical Policies and Guidelines for Below knee, plastic socket, joints and thigh lacer, sach foot

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