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CPT 22511: Lumbosacral Vertebroplasty, Vertebral Augmentation
CPT code 22511 denotes lumbosacral vertebroplasty, a percutaneous vertebral augmentation procedure using image-guided injection of bone cement into a fractured lower spinal vertebra. This code captures a commonly performed intervention for osteoporotic compression fractures and other vertebral body insufficiency when conservative care fails. Nationally, vertebroplasty is significant for its role in pain management, stabilization of the spine, and potential impact on utilization and procedure-site spending.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context outlining indications and typical sites of service, billing considerations tied to the procedure setting, and a summary of common modifier usage when available. The publication also provides national benchmarking context, service-line placement for hospital and ambulatory settings, and notes on documentation elements tied to imaging guidance and potential biopsy content.
This summary equips administrators and billing professionals with the conceptual and operational understanding needed to code and classify lumbosacral vertebroplasty claims accurately and to compare coverage approaches across major national payers. Data not available in the input are identified where relevant.
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Billing Code Overview
CPT code 22511 describes lumbosacral vertebroplasty, a minimally invasive surgical procedure to repair a fractured vertebra in the lower spine. The procedure typically involves percutaneous injection of bone cement into a compromised lumbosacral vertebral body under imaging guidance to stabilize the fracture, reduce pain, and restore structural integrity. A bone biopsy may be performed during the procedure for diagnostic evaluation when indicated.
Service type: Interventional spinal procedure / vertebral augmentation
Typical site of service: Hospital outpatient department, ambulatory surgery center, or specialized imaging-equipped procedural suite