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PAYER POLICY CHANGES

27226 Insurance Policy Changes

CPT 27226, in plain terms, covers Open treatment with internal fixation of a fracture of the anterior or posterior wall of the hip socket (acetabulum). No tracked policy changes reference CPT 27226 yet. New payer updates are added daily, so check back soon or create a free alert to be notified the moment a change affects this code.

Official descriptor: CPT 27226 on AAPC

No policies yet

No tracked policy changes match this filter yet. New policies are added daily.

Watch 27226

Get one email when a payer policy names 27226, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

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REFERENCE DATA

Payers with rules2
Payers requiring prior auth2
  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Community Health Plan of Imperial Valley · Effective December 31, 2025

    Prior authorization required

    Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does CalViva Health require prior authorization for 27226?

CalViva Health lists 27226 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 27226?

Community Health Plan of Imperial Valley lists 27226 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect CPT 27226?

No policy changes affecting CPT 27226 have been tracked yet. Check back as coverage expands.

Which payers have updated policy for CPT 27226?

No payer-specific updates have been tracked for CPT 27226 yet.

How do I get notified when CPT 27226 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 27226. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 27226?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

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Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 27226 in one place.

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