2025 CPT code 22510
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vertebral Augmentation Musculoskeletal System Feed
Percutaneous vertebroplasty of one cervicothoracic vertebral body, including bone biopsy if performed, and all imaging guidance.
Modifiers may apply depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 76 for a repeat procedure). Refer to current CPT guidelines and payer specific rules for details.
Medical necessity is typically established by demonstrating clinical failure of conservative management (pain management, bracing, physical therapy), presence of significant pain impacting daily activities, and radiological evidence of vertebral compression fracture(s) with associated instability or neurological compromise. The procedure may not be deemed medically necessary if the patient is not a candidate (e.g., significant infection, active bleeding diathesis).
The physician is responsible for performing the percutaneous vertebroplasty, including prepping the patient, administering anesthesia (if applicable), injecting the bone cement under image guidance, and potentially performing a bone biopsy.
In simple words: This code covers a minimally invasive procedure to repair a broken vertebra in the neck or upper back.A special cement is injected into the bone to strengthen it.X-rays are used to guide the injection, and a small bone sample might be taken for testing.
Percutaneous vertebroplasty (bone biopsy included when performed), one vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic.This CPT code encompasses the injection of bone cement into a fractured vertebra in the neck or upper back region to reinforce its structure. The procedure is guided by imaging techniques like fluoroscopy or CT scan. A bone biopsy may be performed concurrently, as indicated.
Example 1: A 70-year-old female patient presents with severe back pain due to an osteoporotic compression fracture of a T6 vertebra. After failing conservative treatment, she undergoes percutaneous vertebroplasty (22510) with cement injection and imaging guidance.No biopsy was necessary., A 65-year-old male patient with a recent fall experiences a compression fracture in the C7 vertebra.He undergoes a percutaneous vertebroplasty (22510) with cement injection. A bone biopsy is performed to rule out malignancy., A 58-year-old female patient with multiple osteoporotic compression fractures in C5, C6 and C7 undergoes percutaneous vertebroplasty. The physician codes 22510 for the primary C7 fracture, and adds 22512 for each of the additional fractured vertebrae C5 and C6
Pre-operative imaging (X-ray, CT, or MRI demonstrating the fracture), operative report detailing the procedure, including injection sites, amount of cement used, and biopsy findings (if performed), post-operative imaging to confirm cement placement, and appropriate patient history and physical examination notes.
** Always refer to the most current CPT codebook and payer-specific guidelines for the most accurate and up-to-date coding and reimbursement information.This information is current as of December 3rd, 2024.
- Revenue Code: P5B (AMBULATORY PROCEDURES - MUSCULOSKELETAL)
- RVU: This information is not available in provided sources.Refer to current Relative Value Units (RVUs) from CMS for precise details.
- Global Days: The global period for this procedure is not explicitly defined in the provided sources. Consult current CPT guidelines or payer specific information for specifics.
- Payment Status: Active
- Modifier TC rule: This information is not available in the provided sources. Consult the current CPT guidelines or payer-specific instructions for details on whether a technical component (TC) modifier applies.
- Fee Schedule: Fee schedules vary depending on the payer and geographical location. Historical fee data is not available in provided sources. Consult fee schedules from payers for historical pricing information.
- Specialties:Orthopedic Surgery, Neurosurgery, Interventional Radiology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgery Center