Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
Percutaneous vertebroplasty is a minimally invasive procedure aimed at stabilizing compression fractures in the spine, particularly those caused by osteoporosis. This procedure is also applicable for treating aggressive hemangiomas of the vertebral body and for providing palliative care for pathological fractures resulting from benign or malignant tumors in the spinal region. During the procedure, the patient is positioned prone, allowing the physician to access the lumbar vertebrae effectively. The use of imaging techniques, such as fluoroscopy or computed tomography (CT), is essential for accurately identifying the vertebral level that requires intervention. Local anesthesia is administered to ensure patient comfort throughout the procedure. A spinal needle is then carefully advanced into the targeted vertebral body, where deep local and subperiosteal anesthesia is applied. If a biopsy is indicated, a small incision is made, and a specialized bone biopsy needle is utilized to obtain a sample from the vertebral body for pathological analysis. Following this, the vertebroplasty is performed by injecting a mixture of polymethylmethacrylate (PMMA) bone cement and a contrast medium into the vertebral body, which helps to visualize the distribution of the cement within the bone marrow space. The procedure may involve injections on both sides of the vertebral body, depending on the clinical requirements. This technique is specifically coded under CPT® Code 22521 for a single lumbar vertebra, with additional codes available for thoracic vertebrae and subsequent lumbar vertebrae as necessary.
© Copyright 2026 Coding Ahead. All rights reserved.
Percutaneous vertebroplasty is indicated for the following conditions:
The procedure of percutaneous vertebroplasty involves several critical steps to ensure effective treatment. First, the patient is positioned in a prone manner to provide optimal access to the lumbar vertebrae. Using fluoroscopic or CT guidance, the physician identifies the specific vertebral level that requires intervention. Following this, local anesthesia is administered to minimize discomfort during the procedure. A spinal needle is then advanced into one side of the targeted vertebral body. Deep local and subperiosteal anesthesia is also applied to enhance patient comfort. If a biopsy is necessary, a small incision is made in the skin, and a bone biopsy needle is carefully advanced into the vertebral body to obtain a bone sample, which is subsequently sent for pathological examination. After the biopsy, the vertebroplasty is performed by injecting a mixture of polymethylmethacrylate (PMMA) bone cement and a contrast medium into the vertebral body. This mixture is injected through the spinal needle, allowing the physician to observe its diffusion throughout the intertrabecular bone marrow space. Once the injection is complete, the needle is withdrawn. If required, a second injection may be performed on the opposite side of the vertebral body, with or without the need for an additional biopsy.
After the completion of the percutaneous vertebroplasty, patients are typically monitored for any immediate complications or adverse reactions. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Patients are often advised to avoid heavy lifting or strenuous activities for a specified period. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to monitor the patient's recovery. It is essential for healthcare providers to provide clear guidance on any signs of complications that patients should be aware of, such as increased pain, swelling, or signs of infection at the injection site.
| Short Descr | PERCUT VERTEBROPLASTY LUMB | Medium Descr | PERCUTANEOUS VERTEBROPLASTY LUMBAR W/WO BNE BX | Long Descr | Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection; lumbar | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 9 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | Not applicable/unspecified. | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
Get instant expert-level medical coding assistance.