S2118 Total hip resurfacingMetal-on-metal total hip resurfacing, including acetabular and femoral components
Status I: not valid for Medicare (Medicare uses another code).
25 of 25 payer prior-auth lists that name S2118 require prior authorization or set conditions: Aetna, Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of Illinois, Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Idaho, Molina Healthcare of Illinois, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Mississippi, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of Texas, Molina Healthcare of Utah, Passport by Molina Healthcare (Kentucky).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | AZ Blue-administered Medicare Advantage (M2K) | AZ | prior auth required | Sep 1, 2026 | AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Effective 09/01/2026) | |
| Blue Cross Blue Shield of Arizona (AZ Blue) | Standard PA code list (most commercial plans) | AZ | prior auth required | Sep 1, 2026 | AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026) | |
| Blue Cross Blue Shield of Arizona (AZ Blue) | State of Arizona employee group (SYD, S3Z) | AZ | prior auth required | Sep 1, 2026 | State of Arizona Group Prior Authorization Requirements Code List (09/01/2026) | |
| Aetna | Medicare Advantage | All | prior auth required | Not required for Student Health or Allina Health | Aetna plans | Oct 1, 2026 | Participating provider precertification list for Aetna® |
| Aetna | Commercial | All | prior auth required | Not required for Student Health or Allina Health | Aetna plans | Oct 1, 2026 | Participating provider precertification list for Aetna® |
| Blue Cross and Blue Shield of Illinois | Blue Cross Community Health Plans (BCCHP), Illinois Medicaid | IL | prior auth required | Carelon-managed | Aug 1, 2025 | Illinois Medicaid Prior Authorization Code List, Effective 10/1/2026 |
| Blue Cross and Blue Shield of Illinois | Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative) | IL | prior auth required | eviCore-managed | Jan 1, 2020 | Procedure Code List, Effective 1/1/2025 |
| Molina Complete Care (Virginia) | Medicaid | VA | prior auth required | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 | |
| Molina Healthcare of California | Medicaid | CA | prior auth required | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 | |
| Molina Healthcare of Idaho | Medicaid | ID | prior auth required | Jan 1, 2025 | Idaho Medicaid Prior Auth (PA) Code Matrix and Idaho code/benefit exceptions, Q1 2025 | |
| Molina Healthcare of Illinois | Medicaid | IL | prior auth required | Jan 1, 2022 | Molina Healthcare of Illinois Codification Grid Q3 2026 | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Michigan | Medicaid | MI | prior auth required | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 | |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 | |
| Molina Healthcare of Mississippi | Medicaid | MS | prior auth required | Jan 1, 2025 | Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025 | |
| Molina Healthcare of Nevada | Medicaid | NV | prior auth required | Oct 1, 2022 | Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022 | |
| Molina Healthcare of New Mexico | Medicaid | NM | prior auth required | Jul 1, 2026 | New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026 | |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Medicare and MyCare Ohio (MMP) Medicare | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Exchange | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Texas | STAR | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR+PLUS | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR+PLUS), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix) | TX | prior auth required | Jan 1, 2021 | Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3 | |
| Molina Healthcare of Utah | Medicaid | UT | prior auth required | Jan 1, 2025 | Utah Medicaid Prior Auth (PA) Code Matrix and Utah code/benefit exceptions, Q1 2025 | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth required | Jul 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 |
S2118 appears in 19 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, BlueCross BlueShield of South Carolina, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Hip Arthroplasty (0287) | covered if criteria are met | Sep 23, 2026 | payer document |
| Aetna | Joint Resurfacing (0661) | covered if criteria are met | Oct 7, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Hip Resurfacing | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Hip Resurfacing (046) | listed, no stance | payer document | |
| Blue Shield of California | BSC7.11 | Hip Arthroplasty for Adults | listed, no stance | payer document | |
| Blue Shield of California | | Hip Resurfacing (7.01.80) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Hip Arthroplasty (CAM 771) 27138 | Revision of total hip arthroplasty; femoral component only, with or without allograft | listed, no stance | Jul 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hip Resurfacing (SUR705.019) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (2026T0503KK) | listed, no stance | Sep 10, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (CS056.AA) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Idaho Only) (CS056ID.C) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Kansas Only) (CS056KS.04) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Kentucky Only) (CS056KY.13) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Nebraska Only) (CS056NE.AA) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for New Mexico Only) (CS056NM.F) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for North Carolina Only) (CSNCT0503.07) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Ohio Only) (CS056OH.F) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Pennsylvania Only) (CS056PA.Y) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Surgery of the Hip (for Tennessee Only) (CS056TN.X) | listed, no stance | May 1, 2026 | payer document |
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.