Procedure billing guide

Kyphoplasty and Vertebroplasty Billing and Coding

Vertebroplasty is billed with CPT 22510 (cervicothoracic) or 22511 (lumbosacral) plus 22512 for each additional level. Kyphoplasty, also called vertebral augmentation, is billed with 22513 (thoracic) or 22514 (lumbar) plus 22515 for each additional level. Imaging guidance is included. Payers require imaging that confirms the fracture and documentation of pain and functional limits.

Updated October 12, 2026

Call +1 (631) 482-5622

CPT codes

What are the CPT codes for kyphoplasty and vertebroplasty?

Code	Description
22510	Percutaneous vertebroplasty, cervicothoracic, first level
22511	Percutaneous vertebroplasty, lumbosacral, first level
+22512	Vertebroplasty, each additional level
22513	Percutaneous vertebral augmentation (kyphoplasty), thoracic, first level
22514	Percutaneous vertebral augmentation (kyphoplasty), lumbar, first level
+22515	Vertebral augmentation, each additional level

Codes shown for reference. Always confirm against the current year’s CPT code set and your payer’s policy.

Billing rules

How do you bill kyphoplasty and vertebroplasty?

When do payers cover kyphoplasty and vertebroplasty?

Medicare and most payers cover vertebral augmentation for painful osteoporotic or tumor-related compression fractures when imaging confirms an acute or unhealed fracture and the notes document pain severity and its effect on function. If imaging confirming the fracture is not documented, the claim is usually denied.

Since 2026, Medicare's WISeR model has required prior authorization for percutaneous vertebral augmentation in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington.

How do you code kyphoplasty and vertebroplasty correctly?

Choose the primary code by the spinal region of the first level treated, then add 22512 for each additional vertebroplasty level or 22515 for each additional kyphoplasty level. Imaging guidance is included and not billed separately, and vertebroplasty and kyphoplasty codes are never billed for the same level.

Choose the code by the region of the first level treated, then add 22512 or 22515 for each additional level
Imaging guidance is included and is not billed separately
Do not bill vertebroplasty and kyphoplasty codes for the same level

Common denials

Why are kyphoplasty and vertebroplasty claims denied?

These are the denial reasons we see most often. We check for each one before a claim goes out, instead of finding out from a denial.

Denials we prevent

Imaging confirming the fracture not documented
Missing prior authorization, including under WISeR
Wrong region code for the first level treated

FAQ

Kyphoplasty and Vertebroplasty questions

What is the CPT code for lumbar kyphoplasty?

Lumbar kyphoplasty (vertebral augmentation) is CPT 22514 for the first level and +22515 for each additional level.

Does Medicare require prior authorization for kyphoplasty?

In the six WISeR states, including New Jersey, traditional Medicare has required prior authorization for percutaneous vertebral augmentation since 2026.

Sources

Coverage rules change; always check the current version of each policy and your payer’s own rules.

Keep reading

Related services and procedures

Prior Authorization

Approvals for injections, RFA, SCS and kyphoplasty, matched to each payer's criteria.

Spinal Cord Stimulation

SCS trials, permanent implants, revisions and programming, with prior authorization.

Pain Management Coding

CPT, ICD-10, HCPCS and modifier coding for every interventional pain procedure.

How it works

Let’s look at your billing

Tell us about your practice, your payers and where claims are getting stuck. A pain management billing specialist will get back to you and recommend a plan.

1
Tell us about your practice
Your procedures, payers, billing software and current challenges.
2
We review your billing
We look at where claims are denied, underpaid or delayed.
3
Get a clear plan
We recommend how we can take over or support your revenue cycle.

2 N Commerce Sq, Ste 308, Robbinsville, NJ 08691

Get started

Book a free consultation

Tell us about your practice and we’ll show you where better billing can reduce denials and speed up payment.