Interactive Explainer

The 510(k) process, explained end to end.

Fourteen stops across four phases. Every gate, decision, form, fee and FDA deadline on the pathway, with the pathway finder built in. Click any stop in the journey rail to jump straight to it.

14 min readInteractive

21 CFR 807 subpart E; FD&C Act 513(i); MDUFA (90 FR 35895)

See all fourteen stops ↓

What is a 510(k) submission? A 510(k) — also called a premarket notification — is a submission to the U.S. FDA showing that your medical device is substantially equivalent to a device already legally on the market, called a predicate. Most Class II medical devices reach the U.S. market this way. A successful 510(k) results in FDA clearance (not approval) and a K-number.

Roughly 3,000+ devices clear through the 510(k) pathway every year, making it the most common route to the U.S. market for low-to-moderate-risk medical devices. Unlike PMA approval, a 510(k) earns FDA clearance by demonstrating equivalence to an existing device rather than proving safety and effectiveness from scratch. It's faster and cheaper than PMA — but it has real gates, and most delays come from avoidable mistakes early in the process. This guide walks all 14 of them.

Phase 1 · Strategy

Strategy is the first phase because everything else compounds on the decisions you make here. The next four stops are about narrowing down: which pathway, which classification, which predicate, and how you'll argue your device is substantially equivalent to it. Get any of these wrong and the next six months get expensive.

Stop 01

Do you even need a 510(k)?

Not every device takes the 510(k) road — confirm your pathway before you spend a dollar.

The first decision is which FDA premarket pathway applies. There are four options: 510(k), De Novo, PMA, or none (your device is exempt). Get this wrong and you can spend months building the wrong submission.

Class I
Most are exempt
Class II
Typically a 510(k)
De Novo
Novel, no predicate
PMA
High-risk or implantable

A 510(k) is required when you're introducing a Class II (and a small set of Class I and III) device into commercial distribution, or modifying a legally marketed device in a way that could significantly affect safety or effectiveness. Foreign manufacturers can submit directly to FDA but will need a U.S. Agent as their point of contact.

Where people get stuck: assuming a 510(k) when there's no valid predicate (that's actually a De Novo), or building a full submission for a device that's already exempt.

Pathway finderQuestion 1 · of 1–3

Is there a device already on the U.S. market with the same intended use as yours?

Stop 02

Classify your device

Find your product code and regulation number — they define everything that follows.

Reference page: Device classification

Once the pathway is set, medical device classification gives your device the three labels that will follow it through every step: a product code, a regulation number (21 CFR), and a class (I, II, or III). Class determines pathway; product code determines which FDA guidance documents and special controls apply.

FDA wants a clear match to an existing classification regulation — and reviewers can spot a forced fit instantly. Picking a product code that's convenient rather than correct sets up a predicate mismatch later, which is one of the most common roots of a Not Substantially Equivalent (NSE) decision.

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Stop 03

Find your predicate(s)

Your entire submission stands on the predicate you choose.

Reference page: Predicate devices

Everything in a 510(k) hinges on the predicate. A predicate device is a legally marketed device you'll compare yours to: a previously cleared 510(k), a granted De Novo, a pre-amendments device, or a reclassified one. The bar is that it has the same intended use as your device and hasn't been pulled from the market for safety reasons.

How do you find a predicate device? Most teams start in the FDA 510(k) database, filtering by product code and reading recent clearance summaries to find devices with closely matching intended use and technology. You can lean on a single primary predicate, multiple predicates, or a reference device to support a specific characteristic — but the more you stack, the harder reviewers have to work to follow your argument.

Where teams stumble: choosing a recalled predicate without checking, picking one with a subtly different intended use, or piling on so many predicates that the SE argument loses its anchor.

Stop 04

Set your substantial equivalence (SE) strategy

SE is the whole game — same intended use, and same or defensibly different technology.

Reference page: Substantial equivalence

Substantial equivalence is the legal standard for 510(k) clearance. It's a deceptively short rule with a lot of subtext: your device must have the same intended use as the predicate, and either the same technological characteristics or different ones that don't raise new questions of safety and effectiveness — backed by data.

SE strategy also drives which of the three 510(k) types you'll file:

  • Traditional 510(k) — the default for new devices or significant modifications.
  • Special 510(k) — for modifications to your own previously cleared device when design controls produce reliable results. Faster review (often 30 days).
  • Abbreviated 510(k) — when you can rely on FDA guidance documents, special controls, or consensus standards instead of full head-to-head testing.

The output is an SE comparison table: a side-by-side mapping of every relevant characteristic of your device to the predicate's. Reviewers spend more time on this table than on any other section, and it's where most second-round questions originate. A technological difference that quietly raises a new safety question means more testing. Sometimes it means a kicked-back submission.

Phase 2 · Evidence

Phase 2 is where you generate the evidence FDA will read. The risk analysis decides what testing you actually need; the testing itself is usually the longest and most expensive line item; and a Pre-Sub meeting — if you use it — lets you sanity-check your plan with FDA before you commit.

Stop 05

Risk & hazard analysis

Map the hazards now; they decide what you'll have to test.

A 510(k) needs a structured risk analysis (per ISO 14971) identifying hazards, the harms they can cause, and the controls built into the design. FDA doesn't dwell on the risk file the way they dwell on the SE table — but the risk analysis is the document that decides your testing scope. Treat it as paperwork and you'll discover missing tests halfway through Phase 2.

Risk analysis also feeds your QMS. If you're ISO 13485 certified or building toward FDA's Quality Management System Regulation (QMSR, effective February 2026), the same hazard analysis underwrites both your design controls and your 510(k) submission requirements.

Stop 06

Testing & performance data

The longest, most expensive phase — and the one to plan first.

This is the longest, most expensive phase of a 510(k) — and the one to plan first. Depending on your device you'll need some mix of:

  • Bench / performance testing
  • Biocompatibility (ISO 10993) for any patient-contact device
  • Electrical safety and EMC (IEC 60601) for electromedical devices
  • Software (IEC 62304 + FDA software guidance) for any device with software, including SaMD (Software as a Medical Device)
  • Sterilization and shelf-life for sterile or implantable devices
  • Human factors / usability for non-trivial UIs
  • Cybersecurity for connected devices
  • Clinical data, occasionally — when bench can't fully bridge to the predicate

If you're filing a 510(k) for an AI/ML-enabled medical device, this is also where you scope your Predetermined Change Control Plan (PCCP) — FDA's framework for pre-authorizing future model updates without filing a new submission for each one.

Testing budget
Largest line item

Usually the biggest cost in a 510(k), and entirely device-dependent.

Schedule impact
Longest pole

Plan testing first — it paces everything else.

Running tests in the wrong order, missing a standard, or under-scoping all mean re-testing. Re-testing means time.

Stop 07

Pre-Submission (Q-Sub)

A free conversation with FDA that can save you a review cycle.

Reference page: The Q-Submission Program

The FDA Pre-Submission program (Q-Sub) is a free way to get written FDA feedback on your predicate, test plan, or SE strategy before you submit. It's optional — but on novel or borderline devices it can save you a full review cycle later. Q-Sub requests use the PreSTAR template, FDA's interactive PDF for pre-submission interactions.

Cost
Free

Q-Sub feedback carries no FDA user fee.

Turnaround
70 – 90 days

Written feedback from FDA, or a live meeting.

The trick is asking specific, well-framed questions. “Is this okay?” won't get you anything useful. “Here is our predicate and three alternatives — which would you support for an SE argument?” will.

Not sure this pathway is yours? Send us the device and you get the product code, the class, and whether a 510(k) is required — free, within one working day.

Phase 3 · Build

Phase 3 is the part most people picture when they think “510(k) submission” — drafting the document, packaging it into eSTAR, and paying the user fee. It's also where the strategy from Phase 1 gets tested against reality: inconsistencies between sections become very visible at this stage.

Stop 08

Draft the submission

Turn your strategy and data into the document FDA actually reads.

With strategy and data in hand, drafting means turning everything into the document FDA actually reads: device description, the SE comparison, proposed labeling and Instructions for Use (IFU), indications for use, and performance data summaries. The drafting itself is mostly assembly — the harder problem is keeping the sections internally consistent. An indication in the labeling that the testing doesn't support, or an SE comparison that contradicts the device description, is what reviewers catch and what triggers Additional Information (AI) requests.

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Stop 09

Build the eSTAR package

The mandatory electronic format — and your best defense against rejection.

Reference page: eSTAR

eSTAR is FDA's interactive PDF submission template, mandatory for most 510(k)s since October 1, 2023 (and for IVDs since 2024). Its built-in logic and completeness checks are why the old Refuse-to-Accept rejection pattern (see Stop 12) has collapsed. The mistake is treating the eSTAR template as a formatting step at the very end. Structure your content for it from the start: the package assembles cleanly when you do, and gets messy when you don't.

Stop 10

Pay the MDUFA user fee

FDA won't start reviewing until the fee clears.

Reference page: FDA medical device user fees

Every 510(k) requires a Medical Device User Fee under MDUFA before FDA will begin review. The FY2026 510(k) user fee rates (Oct 1, 2025 – Sep 30, 2026):

Standard 510(k)
$26,067

FY2026 standard MDUFA user fee (90 FR 35895).

Small-business 510(k)
$6,517

25% of standard, with FDA Small Business Determination certification.

Payment is by credit card. Allow a few days to clear before submitting or your package goes on “user fee hold.”

If you’re eligible for small-business status, apply for Small Business Determination (SBD) before you file. Applying is free, the determination is not retroactive, and it saves $21,490 on the 510(k) user fee.

FDA medical device user fees by fiscal year
What you pay FDAUntil 30 Sep 2026From 1 Oct 2026
510(k) submission, standard$26,067$28,653
510(k) submission, small business$6,517$7,163
Establishment registration, each year$11,423$13,785

FY2026: 90 FR 35895 · FY2027: 91 FR 48134

The FDA fee is fixed and published. What a submission costs beyond it depends on the device: what testing already exists, whether a strong predicate exists, and how much of the file has to be built from nothing. Those are answerable questions, but not from a page — they need someone to look at the device itself.

Work out the fee for any submission type

Phase 4 · Review

Phase 4 is FDA's turn. You upload the submission, get screened for completeness, and then a reviewer reads your work. Most of the 510(k) review time on a submission lives here — not because FDA is slow, but because Additional Information requests pause the clock while you respond.

Stop 11

Submit

Upload the eSTAR through the CDRH Portal — the clock starts.

Submissions go through the CDRH Customer Collaboration Portal. The MDUFA fee has to be paid and cleared before upload. The only surprises at this step come from leaving portal access until the last minute.

Stop 12

Screening

Virus scan and technical screening before the review clock runs.

Reference page: Acceptance review and Refuse to Accept

Once you’re in, the submission meets virus scanning and technical screening, anticipated within 15 days. Since eSTAR became mandatory for 510(k) submissions on 1 October 2023, this is what most submissions meet — FDA’s position in writing is that “eSTAR submissions are not anticipated to undergo a refuse to accept (RTA) process.” The CDRH Portal blocks an incomplete eSTAR before it is ever submitted, which is why the gate moved.

A screening failure places the submission on hold. If a complete replacement eSTAR is not received within 180 days, FDA considers the submission withdrawn and closes it.

The Refuse to Accept (RTA) checklist has not gone away — it is what applies to eCopy submissions, and the deadline and the consequence are identical. What differs is the gate and its name. Acceptance review and Refuse to Accept covers both.

Stop 13

Substantive review + Additional Information (AI) requests

The real review — and where most of the calendar time actually goes.

This is the real review. An FDA reviewer reads your SE argument and the data behind it. Within roughly 60 days you'll get a Substantive Interaction — FDA's first signal of where the review is heading. If they need more, they issue an Additional Information (AI) request — sometimes called a 510(k) deficiency letter — which puts the review on hold while you respond. You have up to 180 days to respond; the clock is on you, not them.

The biggest variable in your total 510(k) timeline is how fast and how completely you turn around AI responses. Slow or incomplete replies trigger second-round AIs that stretch the calendar by months and can push the submission toward an NSE decision.

ComplizenWe help you turn 510(k) Additional Information requests around quickly and completely, so you don't lose a cycle.
Stop 14

The decision

Substantially equivalent, and you're on the market.

FDA closes the 510(k) review with one of three outcomes: Substantially Equivalent (SE) — you're cleared, you get a K-number, and you can market the device. Not Substantially Equivalent (NSE)— you can’t market via 510(k); your options are to request De Novo classification, file a PMA, or file a new 510(k) with a different predicate. Or you withdraw and resubmit. An NSE almost always traces back to Phase 1 — a weak predicate or an SE argument that wasn't right to start with. Which is why the first four stops matter most.

Glossary

The terms you'll hit on this pathway.

Plain-English definitions for the acronyms you'll see most on a 510(k) submission.

510(k)

Premarket notification proving a device is substantially equivalent to a legally marketed one.

Substantial Equivalence (SE)

Same intended use, and same or defensibly-different technology vs. the predicate.

Predicate device

A legally marketed device you compare yours to.

Product code

FDA's 3-letter code identifying a device category.

eSTAR

FDA's mandatory interactive PDF submission template for 510(k)s.

MDUFA

Medical Device User Fee Amendments — the law setting FDA review fees.

RTA (Refuse to Accept)

FDA's completeness check before substantive review.

AI request (Additional Information)

FDA's request for more data, which pauses the review clock.

De Novo

Pathway for novel low-to-moderate-risk devices with no predicate.

PMA

Premarket Approval — the most stringent pathway, for high-risk devices.

IFU (Instructions for Use)

The labeling that tells users how to use the device.

CDRH

FDA's Center for Devices and Radiological Health.

K-number

The identifier assigned to a cleared 510(k).

Pre-Sub / Q-Sub

Voluntary pre-submission feedback from FDA, filed via PreSTAR.

Class I / II / III

FDA's medical device risk tiers.

SBD

Small Business Determination, the certification that qualifies you for the reduced 510(k) user fee.

PCCP

Predetermined Change Control Plan, FDA's framework for pre-authorizing updates to AI/ML medical devices.

SaMD

Software as a Medical Device.

QMSR

FDA's Quality Management System Regulation, replacing 21 CFR 820 in February 2026.

Frequently asked

510(k) questions, answered.

What is a 510(k)?

A 510(k) is a premarket notification submitted to the FDA to demonstrate that a medical device is substantially equivalent to a legally marketed device, called a predicate. Most Class II medical devices reach the U.S. market through the 510(k) pathway. A successful 510(k) results in FDA clearance and a K-number.

How long does a 510(k) take?

FDA's MDUFA goal is 90 FDA days to a decision. FDA days are not calendar days: the clock stops while a submission sits on hold for an Additional Information request, and it does not restart until the response is in. How long a given submission takes therefore depends on how many AI requests it draws and how fast each is answered, which is a property of the file rather than of the pathway.

How much does a 510(k) cost?

The FDA fee is fixed and published: $26,067 for FY2026, or $6,517 with a Small Business Determination (90 FR 35895). What a submission costs beyond it depends on the device — what testing already exists, whether a strong predicate exists, and how much of the file has to be built from nothing. Those are answerable questions, but not from a page: they need someone to look at the device itself.

What is substantial equivalence?

Substantial equivalence is the legal standard for 510(k) clearance. Your device must have the same intended use as the predicate, and either the same technological characteristics or different ones that don't raise new questions of safety and effectiveness — backed by performance data.

What is a predicate device?

A predicate device is a legally marketed medical device that you compare your device to in a 510(k) submission to demonstrate substantial equivalence. Valid predicates include previously cleared 510(k) devices, granted De Novo devices, pre-amendments devices, or reclassified devices, as long as they haven't been pulled from the market for safety reasons.

510(k) vs. De Novo vs. PMA — what's the difference?

A 510(k) is for devices substantially equivalent to an existing predicate. De Novo is for novel low-to-moderate-risk devices with no valid predicate. PMA (Premarket Approval) is the most stringent pathway, required for high-risk Class III devices and based on independent clinical evidence rather than equivalence.

Is eSTAR required?

Yes. Since October 1, 2023, eSTAR is mandatory for nearly all 510(k) submissions, and for IVD 510(k)s since 2024. eSTAR's built-in completeness checks have largely replaced the old Refuse to Accept screening process.

Does FDA clearance mean my device is FDA approved?

No. FDA clearance (510(k)) means your device has been shown substantially equivalent to a predicate. FDA approval (PMA) means the agency has independently reviewed clinical evidence of safety and effectiveness. Marketing a 510(k)-cleared device as “FDA approved” is a regulatory violation.

Do I need a 510(k) consultant?

You don't strictly need one, but most first-time submitters use either a 510(k) consultant or a regulatory submission platform to avoid costly mistakes in predicate selection, SE strategy, and eSTAR assembly — the three areas most likely to trigger an Additional Information request or NSE decision.

Can foreign companies submit a 510(k)?

Yes. Foreign manufacturers can submit a 510(k) directly to the FDA but must appoint a U.S. Agent as their official contact. The 510(k) process itself is identical regardless of where the manufacturer is based.

You've seen all 14 stops

Not sure which predicate fits your device?

The pathway above is the same for every device. What differs is your predicate, and that is the first thing we look at.

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