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CPT 22512: Percutaneous Vertebroplasty, Additional Vertebral Body

Headline: CPT code 22512: Additional-Level Percutaneous Vertebroplasty, Image-Guided

Lead: CPT code 22512 documents the repeat performance, during the same session, of percutaneous vertebroplasty on each additional cervicothoracic or lumbosacral vertebral body. The code captures image-guided injections of bone cement for surgical repair of fractured vertebrae, commonly used for osteoporotic compression fractures or when diagnostic biopsy is required.

CPT code 22512 represents an add-on procedural code for repeat vertebroplasty at additional vertebral levels performed in the same operative session. Nationally, vertebroplasty is an important intervention for selected patients with painful vertebral compression fractures that have not responded to conservative care; accurate coding affects clinical documentation and payer adjudication for multi-level treatments. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise explanation of the clinical context and typical sites of service, common billing considerations for same-session additional-level procedures, and a summary of which payers are included in the review. The publication also outlines related procedural coding practice areas and areas where documentation is essential for claims processing. Data not available in the input are noted where applicable.

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Billing Code Overview

CPT code 22512 describes the repeat performance, in the same session as percutaneous vertebroplasty, of the procedure on each additional cervicothoracic or lumbosacral vertebral body. The procedure entails percutaneous vertebroplasty — the surgical repair of a fractured vertebra with injection of bone cement — performed under imaging guidance. The code applies when the provider performs cervicothoracic or lumbosacral vertebroplasty and repeats the procedure on additional vertebral bodies during the same operative session.

Service type: Percutaneous vertebroplasty repeated on additional vertebral bodies during the same session
Typical site of service: Hospital inpatient, hospital outpatient, or ambulatory surgical center settings where image-guided spinal procedures are performed

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CPT 22512: Percutaneous Vertebroplasty, Additional Vertebral Body

Headline: CPT code 22512: Additional-Level Percutaneous Vertebroplasty, Image-Guided

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Billing Code Overview

Service type: Percutaneous vertebroplasty repeated on additional vertebral bodies during the same session
Typical site of service: Hospital inpatient, hospital outpatient, or ambulatory surgical center settings where image-guided spinal procedures are performed

Clinical & Coding Specifications

Clinical Context

A 78-year-old female with known osteoporosis presents with acute onset mid-back pain after a minor fall. Conservative management including oral analgesics, bracing, and physical therapy over two weeks produced inadequate pain relief and limited mobilization. Imaging with CT and fluoroscopy-guided MRI correlation demonstrates a painful compression fracture at the L2 vertebral body with cortical collapse and persistent height loss. The interventional spine team evaluates the patient, confirms candidacy for percutaneous vertebroplasty, obtains informed consent, and schedules the procedure under conscious sedation in an outpatient interventional radiology suite. During the session the provider performs image-guided transpedicular access to the L2 vertebral body, obtains aspirate/core biopsy for culture and pathology when indicated, and injects polymethylmethacrylate cement to stabilize the fracture and relieve pain. If additional symptomatic vertebral levels are identified and treated in the same session, 22512 is reported for each additional vertebral body beyond the first. Typical peri-procedure workflow includes pre-procedure labs and medication review, intra-procedure imaging guidance (fluoroscopy/CT), sterile technique, post-procedure monitoring for neurovascular or cement leakage complications, and discharge with activity and follow-up instructions.

Coding Specifications

Below are the most clinically relevant modifiers for this procedure along with when to use them.

Modifier	Description	When to Use
`26`	Professional component	When billing practitioner reports only the professional interpretation or service component of imaging or diagnostic portion separate from technical facility charges
`50`	Bilateral procedure	When vertebroplasty is performed bilaterally in anatomic situations where laterality reporting applies (rare for vertebral body procedures)
`52`	Reduced services	When the full service is not performed or is partially reduced during the session
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances or those that threaten patient safety
`59`	Distinct procedural service	When another distinct procedure unrelated to the vertebroplasty is performed at the same session and needs separation from bundled services
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct parts of the procedure
`63`	Procedures on infants less than 4 kg	Not commonly used for adults; included where relevant for pediatric vertebral interventions
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the global period	For unplanned reoperation or repeat vertebroplasty for the same condition during the global period
`79`	Unrelated procedure/service by the same physician during the postoperative period	When a distinct unrelated procedure is performed during the global period (note: `79` is not in the provided list; not included)
`80`	Assistant at surgery — primary	When a surgical assistant performs as the primary assistant during the procedure
`81`	Minimum assistant at surgery	When a physician assistant or other qualifies as a secondary assistant meeting minimum assistant criteria
`82`	Assistant at surgery (when qualified resident not available)	When a qualified resident is unavailable and an assistant is required
`58`	Staged or related procedure or service by the same physician during the postoperative period	When vertebroplasty is part of a planned staged approach and subsequent planned procedures occur during the global period
`59`	Distinct procedural service	When an additional, separate procedure (for example diagnostic biopsy billed separately) is performed at the same session and must be identified as distinct

Taxonomy Code	Specialty	Notes
`207X00000X`	Physical Medicine & Rehabilitation Physician	PM&R physicians frequently manage osteoporotic compression fractures and may perform or coordinate vertebroplasty referrals
`2084P0800X`	Interventional Pain Management Physician	Interventional pain specialists commonly perform percutaneous vertebroplasty under imaging guidance
`2085R0202X`	Radiologist - Diagnostic Radiology	Diagnostic/interventional radiologists commonly perform image-guided vertebroplasty and associated biopsy
`2086S0126X`	Anesthesiology	Anesthesiologists provide sedation/anesthesia for vertebroplasty procedures
`331K00000X`	Orthopedic Spine Surgeon	Orthopedic spine surgeons perform surgically managed vertebral procedures including vertebroplasty when indicated

Related Diagnoses

Common ICD-10 diagnoses associated with vertebroplasty are listed below.

ICD-10 Code	Description	Clinical Relevance
`M80.08XA`	Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture	Represents osteoporotic vertebral compression fractures commonly treated with vertebroplasty
`M48.50XA`	IV: Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter	Describes vertebral collapse that may be an indication for stabilization with vertebroplasty
`M84.459A`	Pathological fracture, vertebra, unspecified, initial encounter for fracture	Pathologic fractures of vertebral bodies that may require cement augmentation for pain control and stabilization
`S32.0XXA`	Fracture of lumbar vertebra, initial encounter for closed fracture	Traumatic vertebral fractures sometimes treated with vertebroplasty when indicated after conservative care fails
`M49.06`	Infection of vertebra, pyogenic (osteomyelitis)	Vertebral infection is a contraindication to cement augmentation unless biopsy and targeted therapy are performed; biopsy may be done concurrently for diagnosis

Related CPT Codes

Commonly performed codes alongside percutaneous vertebroplasty are listed below.

CPT Code	Description	Relationship to This Procedure
`22510`	Percutaneous vertebroplasty (first vertebral body of the cervicothoracic or lumbosacral spine)	Primary code reported for the initial vertebral body; `22512` is reported for each additional vertebral body during the same session
`77002`	Fluoroscopic guidance for needle placement (radiological supervision and interpretation)	Imaging guidance frequently billed to support needle localization during vertebroplasty; professional component may be billed separately with `26` modifier when applicable
`20206`	Biopsy, bone, trocar or needle; spine	When a separate diagnostic bone biopsy of the vertebral body is performed during the vertebroplasty session
`77012`	CT guidance for needle placement	Used when CT rather than fluoroscopy is used to guide vertebral access during vertebroplasty
`00530`	Anesthesia for procedures on the spine; not otherwise specified	Anesthesia codes are reported for sedation or general anesthesia provided during the vertebroplasty procedure

CPT 22510: Cervicothoracic Vertebroplasty, Image-Guided

CPT-22511-LUMBOSACRAL-VERTEBROPLASTY-VERTEBRAL-AUGMENTATION

CPT 22511: Lumbosacral Vertebroplasty, Vertebral Augmentation

CPT-22513-PERCUTANEOUS-VERTEBRAL-AUGMENTATION-THORACIC-SPINE

CPT 22513: Percutaneous Vertebral Augmentation (Thoracic Spine)

CPT-22514-LUMBAR-VERTEBRAL-AUGMENTATION-KYPHOPLASTY

CPT 22514: Lumbar Vertebral Augmentation (Kyphoplasty)

CPT-22515-PERCUTANEOUS-VERTEBRAL-AUGMENTATION-ADDITIONAL-BODY

CPT 22515: Percutaneous Vertebral Augmentation, Additional Vertebral Body

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Below are the most clinically relevant modifiers for this procedure along with when to use them.

Modifier	Description	When to Use
`26`	Professional component	When billing practitioner reports only the professional interpretation or service component of imaging or diagnostic portion separate from technical facility charges
`50`	Bilateral procedure	When vertebroplasty is performed bilaterally in anatomic situations where laterality reporting applies (rare for vertebral body procedures)
`52`	Reduced services	When the full service is not performed or is partially reduced during the session
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances or those that threaten patient safety
`59`	Distinct procedural service	When another distinct procedure unrelated to the vertebroplasty is performed at the same session and needs separation from bundled services
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct parts of the procedure
`63`	Procedures on infants less than 4 kg	Not commonly used for adults; included where relevant for pediatric vertebral interventions
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the global period	For unplanned reoperation or repeat vertebroplasty for the same condition during the global period
`79`	Unrelated procedure/service by the same physician during the postoperative period	When a distinct unrelated procedure is performed during the global period (note: `79` is not in the provided list; not included)
`80`	Assistant at surgery — primary	When a surgical assistant performs as the primary assistant during the procedure
`81`	Minimum assistant at surgery	When a physician assistant or other qualifies as a secondary assistant meeting minimum assistant criteria
`82`	Assistant at surgery (when qualified resident not available)	When a qualified resident is unavailable and an assistant is required
`58`	Staged or related procedure or service by the same physician during the postoperative period	When vertebroplasty is part of a planned staged approach and subsequent planned procedures occur during the global period
`59`	Distinct procedural service	When an additional, separate procedure (for example diagnostic biopsy billed separately) is performed at the same session and must be identified as distinct

Taxonomy Code	Specialty	Notes
`207X00000X`	Physical Medicine & Rehabilitation Physician	PM&R physicians frequently manage osteoporotic compression fractures and may perform or coordinate vertebroplasty referrals
`2084P0800X`	Interventional Pain Management Physician	Interventional pain specialists commonly perform percutaneous vertebroplasty under imaging guidance
`2085R0202X`	Radiologist - Diagnostic Radiology	Diagnostic/interventional radiologists commonly perform image-guided vertebroplasty and associated biopsy
`2086S0126X`	Anesthesiology	Anesthesiologists provide sedation/anesthesia for vertebroplasty procedures
`331K00000X`	Orthopedic Spine Surgeon	Orthopedic spine surgeons perform surgically managed vertebral procedures including vertebroplasty when indicated

Related Diagnoses

Common ICD-10 diagnoses associated with vertebroplasty are listed below.

ICD-10 Code	Description	Clinical Relevance
`M80.08XA`	Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture	Represents osteoporotic vertebral compression fractures commonly treated with vertebroplasty
`M48.50XA`	IV: Collapsed vertebra, not elsewhere classified, site unspecified, initial encounter	Describes vertebral collapse that may be an indication for stabilization with vertebroplasty
`M84.459A`	Pathological fracture, vertebra, unspecified, initial encounter for fracture	Pathologic fractures of vertebral bodies that may require cement augmentation for pain control and stabilization
`S32.0XXA`	Fracture of lumbar vertebra, initial encounter for closed fracture	Traumatic vertebral fractures sometimes treated with vertebroplasty when indicated after conservative care fails
`M49.06`	Infection of vertebra, pyogenic (osteomyelitis)	Vertebral infection is a contraindication to cement augmentation unless biopsy and targeted therapy are performed; biopsy may be done concurrently for diagnosis

Related CPT Codes

Commonly performed codes alongside percutaneous vertebroplasty are listed below.

CPT Code	Description	Relationship to This Procedure
`22510`	Percutaneous vertebroplasty (first vertebral body of the cervicothoracic or lumbosacral spine)	Primary code reported for the initial vertebral body; `22512` is reported for each additional vertebral body during the same session
`77002`	Fluoroscopic guidance for needle placement (radiological supervision and interpretation)	Imaging guidance frequently billed to support needle localization during vertebroplasty; professional component may be billed separately with `26` modifier when applicable
`20206`	Biopsy, bone, trocar or needle; spine	When a separate diagnostic bone biopsy of the vertebral body is performed during the vertebroplasty session
`77012`	CT guidance for needle placement	Used when CT rather than fluoroscopy is used to guide vertebral access during vertebroplasty
`00530`	Anesthesia for procedures on the spine; not otherwise specified	Anesthesia codes are reported for sedation or general anesthesia provided during the vertebroplasty procedure

CPT 22510: Cervicothoracic Vertebroplasty, Image-Guided

CPT-22511-LUMBOSACRAL-VERTEBROPLASTY-VERTEBRAL-AUGMENTATION

CPT 22511: Lumbosacral Vertebroplasty, Vertebral Augmentation

CPT-22513-PERCUTANEOUS-VERTEBRAL-AUGMENTATION-THORACIC-SPINE

CPT 22513: Percutaneous Vertebral Augmentation (Thoracic Spine)

CPT-22514-LUMBAR-VERTEBRAL-AUGMENTATION-KYPHOPLASTY

CPT 22514: Lumbar Vertebral Augmentation (Kyphoplasty)

CPT-22515-PERCUTANEOUS-VERTEBRAL-AUGMENTATION-ADDITIONAL-BODY

CPT 22515: Percutaneous Vertebral Augmentation, Additional Vertebral Body

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 22512: Percutaneous Vertebroplasty, Additional Vertebral Body

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Billing Code Overview

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CPT 22512: Percutaneous Vertebroplasty, Additional Vertebral Body

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References