Summary & Overview
HCPCS S2118: Metal-on-Metal Total Hip Resurfacing, Acetabular and Femoral Components
HCPCS Level II code S2118 represents metal-on-metal total hip resurfacing, encompassing both acetabular and femoral components. The code captures a distinct hip preservation surgery that differs from conventional total hip arthroplasty by capping the femoral head rather than replacing the femoral stem. Nationally, this code matters because hip resurfacing has unique clinical indications, implant considerations, and utilization patterns that affect surgical coding, device tracking, and payer coverage policies.
Key payers in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, typical sites of care, and the payer landscape reflected in the analysis. The publication summarizes available benchmarks and policy-relevant points, highlights clinical context for when hip resurfacing is performed, and outlines areas where coverage criteria and device-specific policies commonly influence billing and reimbursement.
The content is organized to help billing managers, clinicians, and policy analysts understand what S2118 denotes, how it differs from other hip arthroplasty codes, and what to consider when reviewing payer coverage language and utilization benchmarks. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code S2118 describes metal-on-metal total hip resurfacing, including acetabular and femoral components. This procedure is a type of hip resurfacing arthroplasty intended to preserve more femoral bone than standard total hip arthroplasty by capping the femoral head and implanting an acetabular component.
Service Type: Surgical procedure — hip resurfacing arthroplasty
Typical Site of Service: Inpatient hospital or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 55-year-old active male with end-stage osteoarthritis of the right hip presents with progressive groin pain, decreased range of motion, and failed conservative therapy including activity modification, physical therapy, and intra-articular corticosteroid injections. Imaging demonstrates advanced degenerative changes of the femoral head and acetabulum with preserved femoral head bone stock and minimal femoral canal deformity, making the patient a candidate for a metal-on-metal total hip resurfacing procedure. The surgical workflow includes preoperative evaluation (medical clearance, templating, and metal allergy screening), perioperative prophylactic antibiotics, general or regional anesthesia, the resurfacing procedure with implantation of metal acetabular and femoral components, intraoperative radiographic confirmation of component position, standard hemostasis and wound closure, and postoperative protocols for pain control, venous thromboembolism prophylaxis, early mobilization with physical therapy, and outpatient or short inpatient recovery. Follow-up includes wound checks, radiographic assessment of component position, and monitoring for metal ion levels and functional recovery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use when no other modifier applies to the service. |