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Below knee, molded socket, shin, sach foot, endoskeletal system

HCPCS code

Name of the Procedure:

Below Knee Amputation Prosthetic Fitting (HCPCS L5301)

  • Common Name(s): Below Knee Prosthesis, BK Prosthesis
  • Technical/Medical Terms: Endoskeletal Prosthesis with Molded Socket, Sach Foot


A below-knee prosthesis with an endoskeletal system is a specialized artificial limb designed for individuals who have undergone a below-knee amputation. This prosthetic device includes a molded socket that fits over the amputated limb, a shin connector, and a solid ankle cushioned heel (SACH) foot that provides stability and mobility.


This prosthesis is used to improve the quality of life for individuals who have lost a leg below the knee. The primary goals are to restore mobility, facilitate daily activities, and enhance overall physical functioning and independence.


  • Severe trauma or injury resulting in below-knee amputation.
  • Vascular diseases or diabetes leading to a lower limb amputation.
  • Congenital limb deficiencies.
  • Infections or tumors necessitating limb removal.


  • Patients may need to undergo a general health assessment.
  • Measurements of the residual limb and fitting assessments will be conducted.
  • Instructions to maintain the skin and soft tissues at the amputation site.
  • Patients must ensure a stable medical condition to avoid complications.

Procedure Description

  1. Initial Consultation: Assessment of the residual limb and patient needs.
  2. Casting: A mold or digital scan of the residual limb is taken for creating a custom-fitted socket.
  3. Fabrication: The prosthesis, including the molded socket, shin, and SACH foot, is manufactured.
  4. Fitting and Alignment: The prosthesis is fitted and adjusted for optimal comfort and function.
  5. Training: Patients are trained on how to use and care for their new prosthesis.

Tools and Equipment: Molding materials, digital scanners, alignment tools, and fitting hardware. Anesthesia: Not typically required as it is a fitting procedure.


The initial fitting and alignment process can take several hours. Multiple sessions over weeks to months may be required for adjustments.


This procedure is typically performed in an outpatient orthopedic or prosthetic clinic.


  • Prosthetist
  • Orthopedic Specialist
  • Rehabilitation Specialist

Risks and Complications

  • Common Risks: Skin irritation, pressure sores, misalignment discomfort.
  • Rare Risks: Prosthetic failure, infection at the amputation site.
  • Management: Adjustments and proper hygiene to mitigate risks.


  • Improved mobility and function.
  • Enhanced quality of life and independence.
  • Ability to perform daily activities more effectively. Benefits may be realized shortly after the patient adjusts to the prosthesis.


  • Initial discomfort as the patient adapts to the prosthesis.
  • Follow-up appointments for adjustments and monitoring.
  • Regular skin checks and prosthetic maintenance.
  • Full adaptation can take several weeks to months.


  • Wheelchair use: Less mobile and less independence.
  • Other prosthetic designs: Some may lack the advanced features or comfort.
  • Each alternative has its own benefits and limitations depending on the patient's condition and requirements.

Patient Experience

  • Initial fitting may cause minor discomfort as adjustments are made.
  • Patients might experience initial learning challenges but will gradually acclimate.
  • Pain management typically involves over-the-counter pain relievers if needed.
  • Comfort measures include proper fitting, use of liners, and gradual increase in prosthesis usage time.

Medical Policies and Guidelines for Below knee, molded socket, shin, sach foot, endoskeletal system

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