Does a Laryngeal Mask Airway (LMA) — a device inserted through the mouth to keep a patient's airway open during anesthesia — qualify for Texas's sales tax exemption for prosthetic devices?

Plain-English summary

A medical device maker asked whether its Laryngeal Mask Airway (LMA) qualifies as an exempt prosthetic device under Tex. Tax Code § 151.313. The device is inserted through a patient's mouth into the pharynx and inflated to seal over the larynx, creating an unobstructed airway that lets oxygen and carbon dioxide flow in and out of the lungs when there's an obstruction (or risk of one) in the natural airway.

The Comptroller compared the LMA to an endotracheal tube — another device that provides an airway from the mouth to the larynx and was already treated as an exempt prosthetic — and found the LMA "acts in a manner similar to" that device. On that basis, the LMA qualifies for the prosthetic device exemption.

What this means for you

Medical device manufacturers and distributors

If your product functionally replaces or restores a bodily function or passage the way the LMA replaces an obstructed airway — and it's meaningfully similar to an already-recognized prosthetic device like an endotracheal tube — you have a reasonable basis to seek prosthetic-device exemption treatment. The comparison to an existing recognized device (rather than the LMA's own regulatory classification) was the deciding factor here.

Hospitals, surgical centers, and anesthesia providers

Laryngeal Mask Airways purchased for patient use should qualify for Texas's sales tax exemption on prosthetic devices under Tex. Tax Code § 151.313.

Accountants and tax professionals

This is a useful example of the Comptroller's functional-comparison approach to prosthetic device classification: rather than analyzing the LMA under a novel framework, the ruling anchors the analysis to how the device functions relative to an already-accepted comparable device (the endotracheal tube).

Common questions

Q: Does a Laryngeal Mask Airway (LMA) qualify for Texas's medical device sales tax exemption?
A: Yes — it qualifies as an exempt prosthetic device under Tex. Tax Code § 151.313.

Q: Why does the LMA qualify as a prosthetic device?
A: Because it functions similarly to an endotracheal tube, which is already treated as exempt — both provide an airway from the mouth to the larynx, allowing oxygen and carbon dioxide to flow in and out of the lungs.

Q: Can I rely on this letter for a different medical device?
A: No. This opinion is based on the facts submitted and current law; other facts, though similar, may result in different answers. A device would need its own comparably close functional analogy to an established exempt device.

Citations and references

Statutes:

• Tex. Tax Code § 151.313 (exemption for prosthetic devices)

Source

• STAR search: https://star.comptroller.texas.gov/search?doc_type_code=L&tax_type_code=SST
• Opinion: https://star.comptroller.texas.gov/view/200005259L

Original ruling text

May 3, 2000

Dear ***:

Thank you for your recent letter concerning the taxability of the Laryngeal
Mask Airway. Thank you for providing the brochures on the product.

Information Provided: CORPORATION requests that the State determine the
taxability of the Laryngeal Mask Airway (LMA). CORPORATION believes that the
LMA qualifies for exemption from sales tax as a prosthetic device under Texas
Tax Code Section 151.313.

The lungs provide for the oxygenation of the body's tissues. The pharynx is a
set of tissues providing a passageway for air in and out of the lungs and is
considered part of the body's respiratory tract. An artificial airway is
required when there exists or there is a potential for an obstruction to this
passageway. The LMA is inserted through the mouth into the patient's pharynx
and is inflated to form a seal over the patient's larynx. Thus, the LMA
provides an unobstructed airway from the mouth to the larynx allowing the flow
of oxygen and carbon dioxide in and out of the lungs.

The endotracheal tube also provides an airway from the mouth to the larynx. The
LMA acts in a manner similar to the endotracheal tubes.

Response: The Laryngeal Mask Airway qualifies for exemption as a prosthetic
device.

The State Tax Automated Research (STAR) system, which provides viewing and
downloading of our rules, the Tax code, edited letter rulings, hearings,
Attorney General Opinions, etc., may be accessed on the Internet at:
http://www.window.state.tx.us/

This opinion is based on the facts you submitted and current law. Other facts
though similar, may result in different answers.

If you have any questions or need more information, I'll be glad to help you.
Please call me toll free at 1-800-531-5441, extension 5-0330. My direct line is
512/475-0330. My email address is .

Sincerely,

Bettie Peterson
Tax Policy Division