Summary & Overview

CPT 0200T: Sacral Augmentation for Fractured Sacrum

CPT code 0200T designates a minimally invasive sacral augmentation procedure in which a provider injects cement material into one side of a fractured sacrum, optionally creating a cavity with a balloon or mechanical device and using imaging guidance and bone biopsy. This code is relevant nationally as sacral insufficiency fractures and traumatic sacral fractures are increasingly managed with percutaneous augmentation techniques to reduce pain and improve stability, affecting inpatient and outpatient procedural volumes and payer coverage policies.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for sacral augmentation, typical sites of service (hospital outpatient departments, ambulatory surgical centers, interventional radiology suites), and the service type classification. The publication outlines common modifiers and coding considerations where available. It also provides benchmarks and policy-relevant insights when present in payer determinations, and highlights areas where data are not available in the input.

This summary is intended for national audiences including coding professionals, reimbursement analysts, and clinical program managers seeking a clear description of what CPT code 0200T represents, where it is typically performed, and which major payers to consider when evaluating coverage and billing strategies.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0200TCPTsacral-augmentationvertebral-augmentationinterventional-radiologyoutpatient-proceduresspine-fracture-treatment

Billing Code Overview

CPT code 0200T describes a sacral augmentation procedure in which the provider injects bone cement through a needle into one side of a fractured sacrum. The procedure may include creating a cavity in the sacral body using a balloon or mechanical device, and may be performed with imaging guidance and bone biopsy.

Service Type: Minimally invasive sacral augmentation / vertebral augmentation

Typical Site of Service: Hospital outpatient department or ambulatory surgical center, with possible performance in an interventional radiology suite or similar imaging-equipped procedural setting.

Clinical & Coding Specifications

Clinical Context

A 78-year-old female with severe osteoporosis presents with progressive low back and buttock pain after a ground-level fall. Imaging (CT and MRI) demonstrates an acute non-displaced fracture of the sacral ala with persistent pain limiting ambulation despite conservative measures (analgesics, physical therapy, and bracing) for 4–6 weeks. The interventional spine team schedules a sacroplasty under conscious sedation in an outpatient interventional radiology suite. The procedure is performed with fluoroscopic or CT guidance: after sterile preparation and local anesthesia, a percutaneous needle is advanced into the sacral fracture under image guidance. Bone cement (polymethylmethacrylate) is injected into the fracture zone; a balloon or mechanical cavity-creation device may be used prior to cement placement depending on anatomy. A single-side augmentation is completed with intra-procedural imaging to confirm cement distribution and to monitor for extravasation. The patient is observed post-procedure for recovery from sedation and neurovascular status, receives post-procedure pain assessment and discharge instructions, and is followed up in clinic within 1–2 weeks for evaluation of pain relief and mobilization.

Typical Site of Service

Outpatient interventional radiology or ambulatory surgery center; may also be performed in a hospital-based procedure suite depending on patient comorbidities.

Service Type

Percutaneous sacral augmentation (sacroplasty) with image guidance and possible cavity creation — minimally invasive cement augmentation to stabilize sacral insufficiency or traumatic sacral fractures and reduce pain.

Coding Specifications

Modifier	Description

Taxonomy Code	Specialty	Notes
207P00000X	Physical Medicine & Rehabilitation (Physiatry)	Physiatrists may perform image-guided sacral augmentations in some interventional spine practices.
2080P0015X	Interventional Pain Medicine	Common specialty performing percutaneous sacral augmentation for pain management.
363L00000X	Interventional Radiology	Frequently performs image-guided sacroplasty in outpatient or hospital procedure suites.
207L00000X	Orthopedic Surgery	Orthopedic spine surgeons may perform sacral augmentation in operative or hybrid suites.
208000000X	Anesthesiology (if providing anesthesia services)	Involved when anesthesia beyond local sedation is used; include for billing taxonomy alignment.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M80.08XA`	Age-related osteoporosis with current pathological fracture, sacrum, initial encounter for fracture	Indicates osteoporosis-related sacral fracture which is a primary indication for sacroplasty to stabilize fracture and reduce pain.
`S32.83XA`	Fracture of sacrum, initial encounter for closed fracture	Represents an acute traumatic sacral fracture where cement augmentation may be indicated for pain control and stabilization.
`M84.38XA`	Pathological fracture, sacrum, initial encounter	Applies to non-traumatic pathological fractures of the sacrum (e.g., metastatic disease, insufficiency fractures) considered for sacral augmentation.
`M51.36`	Other intervertebral disc degeneration, sacral and sacrococcygeal region	Degenerative sacral conditions may contribute to pain and sometimes factor into the decision for targeted augmentation in complex cases.
`M48.59`	Other spondylosis with radiculopathy, sacral region	May be listed as a comorbid spinal degenerative diagnosis when documenting pain sources and procedural indication.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77012`	CT guidance for biopsy, aspiration and/or injection; diagnostic, percutaneous	Used when CT guidance is used during needle placement for sacral cement injection or when image-guided biopsy is performed during the session.
`77002`	Fluoroscopic guidance for needle placement (radiological supervision and interpretation)	Used when continuous fluoroscopic guidance is used to place the needle and monitor cement injection; provides the image guidance component.
`20930`	Allograft, morselized, or placing bone graft, any material, including synthetic bone graft	May be reported if adjunctive bone graft material is placed in conjunction with stabilization, depending on payer rules (use with caution).
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., injections into sacroiliac-related spaces when diagnostic or therapeutic injections precede augmentation)	May be performed diagnostically or therapeutically prior to decision for sacroplasty in the diagnostic workflow.
`99024`	Postoperative follow-up visit, normally included in global period	Reported separately only if payer allows separate postoperative visit billing outside the global period; otherwise, part of global care for the procedure.

`00`	No modifier reported / Not specified	Rarely used on claims; include only if payer requires an explicit non-modifier indicator per local billing practice.
`22`	Increased procedural services	Use when work, time, or complexity of the sacroplasty substantially exceeds typical expectations (document rationale).
`23`	Unusual anesthesia	Use when emergency or medically necessary anesthesia is provided that is not typically used for the procedure (document reason).
`50`	Bilateral procedure	Use if sacral augmentation is performed on both sides and the payer requires a bilateral modifier rather than separate codes.
`51`	Multiple procedures	Use when sacroplasty is billed in the same session with other unrelated procedures and payer requires a multiple-procedure modifier.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as documented (e.g., aborted prior to cement injection).
`53`	Discontinued procedure	Use when the procedure is terminated for patient-related or clinical reasons before completion.
`62`	Two surgeons	Use when two surgeons from different specialties are required and both provide distinct services during the same operative session.
`66`	Surgical team	Use when a documented surgical team approach is used for complex cases requiring multiple specialists.
`78`	Unplanned return to OR	Use when an unplanned return to the operating/procedure room for related treatment is required during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is required and payer recognizes assistant surgeon payment.
`81`	Minimum assistant surgeon	Use when a minimal assistant role is documented and payer requires this modifier.
`82`	Assistant surgeon (when a qualified resident not available)	Use when an assistant is used because no qualified resident is available and documentation supports it.
`QK`	Medical direction of two or more CRNAs by physician	Use when the physician medically directs multiple CRNAs during anesthesia for the procedure.