0814T CPT Percutaneous Femur Injection Reimbursement | OpenPayer

Summary & Overview

CPT 0814T: Percutaneous Calcium-Based Bone Graft Injection, Proximal Femur

CPT code 0814T describes a percutaneous, image-guided injection of a calcium-based, resorbable bone graft substitute into the proximal femur (upper thigh bone) on one side of the body. This minimally invasive procedure promotes bone formation and is relevant for treating focal bone defects or augmentation needs in the femoral region. Nationally, the code matters as imaging-guided biologic augmentation procedures expand and payers evaluate coverage and payment for emerging bone-substitute therapies.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service, typical sites of care, common billing modifiers, and where to look for coding and coverage variations across major payers. The publication also summarizes relevant benchmarks and policy considerations affecting reimbursement for percutaneous bone graft substitute injections, outlines coding nuances tied to laterality and imaging guidance, and highlights clinical context for utilization.

This national-level briefing is intended to inform billing staff, revenue cycle managers, and policy analysts about the code’s clinical intent, expected settings of service, and the landscape of payer engagement for image-guided bone graft substitute procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0814TCPTbone graft substitutepercutaneous injectionimage-guided procedureproximal femurambulatory surgical centerhospital outpatient

Billing Code Overview

CPT code 0814T describes a percutaneous injection of a calcium-based, resorbable bone graft substitute into the proximal femur (upper thigh bone) using image guidance. The injected material is designed to resorb naturally and promote bone growth at the treatment site. The procedure is performed through the skin and targets a single side of the body.

Service type: Image-guided percutaneous bone graft substitute injection
Typical site of service: Hospital outpatient department or ambulatory surgical center; procedure is performed at the proximal femur via percutaneous access

Clinical & Coding Specifications

Clinical Context

A 72-year-old ambulatory patient with osteoporotic insufficiency fracture of the proximal femur presents with persistent pain and limited weight-bearing despite conservative care. Imaging (X-ray and CT) demonstrates a nondisplaced insufficiency fracture of the femoral neck or intertrochanteric region with evidence of bone loss. The orthopedic or interventional musculoskeletal specialist performs a percutaneous, image-guided injection of a resorbable calcium-based bone void filler into the proximal femur (one side) to augment structural support and promote bone healing. The procedure is performed in an outpatient ambulatory surgical center or hospital interventional radiology suite under fluoroscopic or CT guidance with local anesthesia and conscious sedation as needed. Pre-procedure steps include informed consent, review of relevant labs (coagulation), and cross-sectional imaging; intra-procedure steps include sterile setup, localization with imaging, percutaneous trocar placement into the femoral metaphysis, injection of the calcium-based material under continuous imaging, and hemostasis; post-procedure steps include recovery monitoring, neurovascular check, post-procedure imaging to document placement, and discharge instructions for restricted weight-bearing and follow-up clinic visit within 2–6 weeks.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work, time, or technical difficulty substantially exceeds typical requirements for this procedure.

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Primary specialty performing femoral augmentation procedures for fracture support.
2084P0800X	Interventional Radiology	Performs percutaneous, image-guided injections and cement/biomaterial placement.
2086S0105X	Pain Medicine	May perform image-guided bone augmentation procedures in select practices.
208000000X	General Surgery	Occasionally involved when surgical management overlaps; less common for percutaneous injections.
363L00000X	Anesthesiology	Provides monitored anesthesia care or sedation for the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M84.451A`	Pathological fracture, right femur, initial encounter for fracture	Osteoporotic/pathologic femoral fractures are primary indications for proximal femoral augmentation.
`M84.452A`	Pathological fracture, left femur, initial encounter for fracture	Same relevance when the left femur is affected.
`M84.459A`	Pathological fracture, femur, unspecified site, initial encounter for fracture	Used when exact femoral site not specified but pathology warrants augmentation.
`M80.061A`	Age-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture	Describes osteoporosis with acute fracture necessitating structural support.
`M80.062A`	Age-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture	Left-sided equivalent for coding laterality.
`S72.001A`	Fracture of unspecified part of neck of femur, right, initial encounter for closed fracture	Traumatic or insufficiency femoral neck fractures that may be managed with augmentation in select cases.
`S72.002A`	Fracture of unspecified part of neck of femur, left, initial encounter for closed fracture	Left-sided counterpart for laterality reporting.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77012`	CT guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiologic supervision and interpretation	May be billed when CT imaging is used to guide trocar placement and material injection for `0814T`.
`77002`	Fluoroscopic guidance for needle placement (eg, vascular, osseous), radiological supervision and interpretation	Used when fluoroscopic guidance directs the percutaneous injection procedure.
`20610`	Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance	May be used if a separate joint injection is performed in the same encounter (distinct from the bone injection).
`20926`	Tissue grafts, other (eg, paraspinous, muscles, fascia), includes obtaining graft when performed, open; each additional graft	May be used when additional bone grafting procedures are performed surgically in conjunction with percutaneous augmentation (less common).
`99024`	Postoperative follow-up visit, included in global service, postoperative visit	Used to report subsequent postoperative visits if payer requires separate reporting (many payers include follow-up in global period).