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FDA Regulatory Pathway Decision Tool

Choosing the right regulatory pathway is critical for your medical device's time-to-market and development costs. This tool helps you determine whether 510(k), De Novo, or PMA is the appropriate pathway based on your device's characteristics and risk profile.

510(k)

3-6 mo

510(k)+

4-12 mo

De Novo

6-12 mo

PMA

1-3 yr

Classification Tool510(k) Guide

FDA Regulatory Pathway Decision Tool

Determine the appropriate FDA submission pathway for your device

FDA Premarket Submission Decision Tree

High-Level FDA Regulatory Pathway Overview

🏥 New Medical Device
📋 Clinical Study
(IDE Required)
SRNSR
or
🛒 Marketing
(Clearance/Approval)
Device Classification

Class I

Low Risk

Usually Exempt

Class II

Moderate Risk

510(k) / De Novo

Class III

High Risk

PMA Required

Possible Pathways
510(k)De NovoPMAHDEExempt
510(k) Pathways
De Novo / Novel
PMA (Class III)
IDE (Clinical)

Understanding Class I Devices

Class I devices are low-risk and subject to General Controls only. Most are exempt from 510(k) premarket notification.

510(k) Exemption

~75% of Class I devices exempt from premarket notification (check 21 CFR 862-892)

QSR Exemption

Many Class I also exempt from full QSR (21 CFR 820), but must follow general controls

Answer questions to find your specific pathway

Special Pathways

Breakthrough

Priority review for life-threatening conditions

EUA

Emergency Use Authorization only

Custom Device

≤5 units/year, specific patient

PDP

Product Development Protocol

Safety & Perf. 510(k)

FDA-published criteria pathway

All FDA Regulatory Pathways

Premarket Submission Pathways

Traditional 510(k)

90-180 days (FDA goal: 90 days)

Clinical: sometimes

Special 510(k)

30 days (FDA goal)

Clinical: never

Abbreviated 510(k)

60-90 days

Clinical: never

Safety & Performance Based 510(k)

60-90 days

Clinical: never

De Novo

150 days (FDA goal)

Clinical: sometimes

PMA

180 days FDA review + clinical trial time (often 1-5 years total)

Clinical: always

PMA Supplement

30-180 days depending on type

Clinical: sometimes

Exempt

No FDA review required

Clinical: never

PDP

Similar to PMA (1-5 years)

Clinical: always

Special Pathways

HDE

75 days (FDA goal)

EUA

Variable (days to weeks during emergency)

Breakthrough Designation

Uses underlying pathway (510(k), De Novo, PMA) with priority review

Custom Device

No FDA review required

Investigational Pathways (21 CFR 812)

IDE (Significant Risk)

30 days FDA review + study duration

21 CFR 812

IDE (Nonsignificant Risk)

IRB approval + study duration

21 CFR 812.2(b)

IDE Exempt

IRB approval + study duration

21 CFR 812.2(c)

Small Business Fee Reductions

Save up to 75%

FDA's Small Business Determination (SBD) Program offers significantly reduced user fees for businesses with ≤$100M gross receipts.

Qualification Requirements

  • Gross receipts or sales ≤$100 million
  • Apply through CDRH's SBD Program
  • Get certified before submission

Additional Benefits

  • First PMA fee waiver (≤$30M receipts)
  • Registration fee waiver (≤$1M)
  • ~75% off most submission fees
SBD Program DetailsFY2026 Fee Schedule

Important Disclaimer

This tool provides preliminary guidance only. FDA has final authority on pathway requirements. Pre-Submission (Q-Sub) meetings with FDA are recommended for novel or complex devices. User fees shown are FY2026 MDUFA rates and subject to annual adjustment.

Pathway Comparison

Factor510(k)De NovoPMA
Predicate RequiredYesNoNo
Typical Device ClassII (some III)I or IIIII
Clinical DataSometimesSometimesUsually
FDA User Fee (FY2026)$26,067$173,782$579,272
Review Timeline~90 days~150 days~180 days
Standard of ReviewSubstantial EquivalenceGeneral/Special ControlsSafety & Effectiveness

Key Regulatory Concepts

Substantial Equivalence (SE)

For 510(k), you must show your device has the same intended use as the predicate and either: (1) same technological characteristics, or (2) different characteristics that don't raise new safety/effectiveness questions.

Predicate Device

A legally marketed device that your device is compared to. Can be a pre-1976 device, a 510(k)-cleared device, a De Novo device, or a reclassified device.

Pre-Submission (Q-Sub)

A meeting or written feedback request with FDA to discuss regulatory pathway, testing requirements, or clinical study design before submitting your application.

IDE (Investigational Device Exemption)

Required for clinical studies of significant risk devices. Allows investigational use while gathering data for regulatory submission.

21 CFR 812: Investigational Device Exemption (IDE)

IDE regulations govern how clinical studies of investigational devices may be conducted in the US. The type of IDE required depends on the device's risk determination.

Study TypeFDA ApprovalIRB ApprovalKey Requirements
Significant Risk (SR)RequiredRequiredFull IDE submission, 30-day FDA review, ongoing reporting, AE reporting within 10 days
Nonsignificant Risk (NSR)Not RequiredRequiredAbbreviated requirements per 812.2(b), sponsor makes NSR determination with IRB concurrence
Exempt (812.2(c))Not RequiredRequiredLegally marketed devices, certain IVDs, consumer preference studies

Significant Risk Device Criteria (21 CFR 812.3(m))

A device is Significant Risk if it:

  • Is intended as an implant
  • Is used in supporting or sustaining human life
  • Is of substantial importance in diagnosing, curing, mitigating, or treating disease
  • Otherwise presents a potential for serious risk to the health, safety, or welfare of a subject
FDA IDE Guidance21 CFR Part 812 Full Text

When to Use Each Pathway

510(k) - Substantial Equivalence

Use when:

  • You have identified a valid predicate device
  • Same intended use as predicate
  • Same or similar technology to predicate
  • Any differences don't raise new safety questions

De Novo - Novel Low/Moderate Risk

Use when:

  • No valid predicate device exists
  • Device presents low-to-moderate risk
  • General and special controls can address risks
  • PMA level of evidence not warranted

PMA - High Risk Devices

Use when:

  • Device is Class III with no predicate
  • Life-sustaining or life-supporting device
  • Device presents substantial risk of harm
  • Clinical evidence of safety and effectiveness needed

FDA Resources

Premarket Submission Selection

FDA guidance on choosing submission type

How to Market Your Device

Complete device marketing overview

Pre-Submissions (Q-Sub)

Get FDA feedback before submission

Clinical Evidence Guidance

When and what clinical data is needed

Real-World Evidence (RWE)

Using RWD in regulatory decisions

Breakthrough Devices Program

Expedited development and review

Related Resources

Device Classification Tool

Determine FDA device class (I, II, III)

510(k) Submission Guide

Complete guide to 510(k) preparation

PMA Submission Guide

Premarket Approval requirements