2025 CPT code 22512
(Active) Effective Date: N/A Revision Date: N/A Surgery - Vertebral Augmentation Musculoskeletal System Feed
Percutaneous vertebroplasty of each additional cervicothoracic or lumbosacral vertebral body; includes all imaging guidance.
Modifiers 51 (multiple procedures), 59 (distinct procedural service), 76 (repeat procedure), and possibly others, may be applicable depending on the circumstances. Refer to the CPT manual and local payer guidelines for detailed modifier usage rules.
Medical necessity for percutaneous vertebroplasty is typically established by the presence of symptomatic osteoporotic compression fractures that haven't responded to conservative management (e.g., pain medication, bracing). The procedure is indicated when the pain significantly impacts the patient's quality of life and conservative approaches have failed.In cases of pathologic fractures due to metastatic disease, it may be medically necessary to stabilize the spine and alleviate pain.
The physician performing the vertebroplasty is responsible for patient assessment, appropriate selection of the vertebroplasty candidate, performing the procedure under image guidance, managing potential complications, and providing appropriate post-operative care.This may involve obtaining informed consent, prepping the patient, administering anesthesia (if applicable), injecting the bone cement accurately, performing bone biopsy (if needed), and interpreting the results of imaging and biopsy. Post-operative care includes pain management and monitoring for complications.
- Musculoskeletal System
- Musculoskeletal System > Surgical Procedures on the Musculoskeletal System > Vertebral Augmentation
In simple words: This code describes the extra cost for treating additional vertebrae in the neck, upper, or lower back using a minimally invasive procedure that involves injecting special cement to strengthen the bones.This is only used if other vertebrae are treated in the same session.It is added to the bill for the main treatment of the first vertebra.
This CPT code, 22512, represents the percutaneous vertebroplasty procedure for each additional cervicothoracic or lumbosacral vertebral body beyond the initial one.It includes the injection of bone cement (e.g., methyl methacrylate) into the vertebral body under image guidance (fluoroscopy or CT) to reinforce the structure.A bone biopsy may be included if performed. This add-on code is always reported in addition to the primary procedure code (22510 or 22511) for the first vertebral body treated.
Example 1: A 70-year-old female patient presents with an osteoporotic compression fracture of T12. After failing conservative treatment, percutaneous vertebroplasty is performed at T12 (22510).During the procedure, an additional compression fracture is detected at T11 requiring vertebroplasty at that level as well.22512 is reported for the additional vertebral level (T11)., A 65-year-old male patient with osteoporosis suffers from multiple compression fractures at L1, L2, and L3.A percutaneous vertebroplasty procedure is performed.The initial treatment of L1 is coded as 22511.Code 22512 is appended to reflect the additional treatment for L2 and L3., A 55-year-old patient with a history of metastatic bone disease develops a pathologic fracture in the thoracic spine at T7. Percutaneous vertebroplasty is performed with bone biopsy. An additional pathologic fracture at T6 also needs vertebroplasty.22510 is billed for the initial level (T7), and 22512 for T6.
Preoperative documentation should include patient history, physical examination findings, radiographic images (x-rays, CT, MRI) demonstrating the compression fracture(s), and assessment of the patient's overall health. Intraoperative documentation should include the specific vertebral levels treated, type and amount of cement injected, imaging documentation during the procedure, and any biopsy performed with its results. Postoperative documentation should include any complications, pain management, and follow-up imaging.
** Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement.The information provided is for guidance only and should not be considered definitive medical or billing advice.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: Refer to CMS conversion factors and local payer information for RVU values and reimbursement rates.RVUs will vary based on geographic location and facility type.
- Global Days: The global period for vertebroplasty is not explicitly defined in the CPT guidelines, but it is assumed to be relatively short, likely encompassing only the immediate postoperative period.Consult local payer guidelines for specifics.
- Payment Status: Active
- Modifier TC rule: TC modifier is not applicable to this code.
- Fee Schedule: Fee schedule information varies by payer and geographic location.Refer to publicly available fee schedules or contact individual payers for historical fee information.
- Specialties:Orthopedic Surgery, Neurosurgery, Pain Management
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)