`S2115` Periacetabular osteotomy

Osteotomy, periacetabular, with internal fixation

Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)

Medicare pricing for S2115

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for S2115

2 of 2 payer prior-auth lists that name S2115 require prior authorization or set conditions: Aetna.

Payer	Plan	State	Prior auth	Conditions	Since	Source
Aetna	Commercial	All	prior auth required		Oct 1, 2026	Participating provider precertification list for Aetna®
Aetna	Medicare Advantage	All	prior auth required		Oct 1, 2026	Participating provider precertification list for Aetna®

Payer coverage policies that name S2115

S2115 appears in 2 coverage policies from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Hip Preservation Surgery (0736)	listed, no stance	Jul 31, 2026	payer document
Aetna	Nerve Blocks (0863)	listed, no stance	Jul 23, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

CO: $354.67 (health_first_colorado), effective Jul 1, 2026
ND: $0.00 (physician), effective Aug 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

S2115 Periacetabular osteotomy