Summary & Overview
HCPCS S2117: Arthroereisis, Subtalar
HCPCS Level II code S2117 denotes subtalar arthroereisis, a surgical implant procedure used to restrict excessive subtalar motion most commonly for symptomatic flexible flatfoot or subtalar instability. Nationally, this code is relevant for surgical billing in orthopedic and podiatric practices that perform foot and ankle reconstructive procedures and for payers managing coverage and utilization of device-based interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what the code represents, the typical clinical context for service delivery, and what to expect in payer coverage discussions. The publication outlines benchmarks and utilization context, common billing modifiers and coding considerations when documented (input lists common modifiers), and policy themes that influence coverage decisions for device-based subtalar procedures.
This summary provides clinicians, billing professionals, and policy analysts with a focused reference on the clinical nature of S2117, the typical sites of service, and the payer landscape to inform coding, claims submission, and policy review at a national level. Data not available in the input is noted where applicable in detailed sections.
Billing Code Overview
HCPCS Level II code S2117 describes arthroereisis, subtalar. This procedure involves placement of an implant or device to limit excessive motion of the subtalar joint, typically performed to address symptomatic flexible flatfoot deformity or subtalar instability. The service type is a surgical orthopedic procedure of the foot and ankle. The typical site of service is an outpatient hospital operating room or ambulatory surgery center, and it may also be performed in an inpatient surgical setting when clinically indicated.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or young adult presenting with symptomatic flexible flatfoot causing pain, recurrent ankle instability, and difficulty with activity. Conservative measures (orthotics, physical therapy, NSAIDs) have failed. The orthopedic surgeon evaluates history, physical exam showing hindfoot valgus and subtalar joint hyperpronation, and weight-bearing radiographs demonstrating a flexible planovalgus deformity. After shared decision-making, the patient is scheduled for subtalar arthroereisis (S2117) as a minimally invasive adjunct to restore subtalar joint alignment.
Preoperative workflow includes preauthorization when required, documentation of symptoms, failed conservative care, and imaging. On the day of surgery the patient undergoes general or regional anesthesia; the surgeon places an implant in the sinus tarsi or subtalar joint to limit pronation. Intraoperative imaging confirms implant position. Typical sites of service are an ambulatory surgery center or hospital outpatient department. Postoperative care includes immobilization in a boot, activity restrictions, wound checks, and follow-up radiographs to monitor position and symptom resolution. Potential later steps include implant removal if symptomatic or additional reconstructive procedures if residual deformity persists.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |