CPT code 22511: Vertebroplasty, lumbosacral, one vertebral body2026 Medicare rate & RVUs in Kentucky
Percutaneous vertebroplasty places cement in one lumbosacral vertebral body, typically to treat a painful compression fracture without mechanical cavity creation.
In Kentucky, Medicare pays $1,604.45 for 22511 in the office and $348.72 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 22511 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 22511 covers
This percutaneous procedure stabilizes one lumbosacral vertebral body by injecting bone cement, usually to treat a painful compression fracture related to osteoporosis or a destructive lesion. An interventional radiologist, neuroradiologist, or spine surgeon typically performs it under imaging guidance in a hospital outpatient department or ambulatory surgery center. It does not use a balloon or other mechanical device to create a cavity. A bone biopsy performed during the procedure is included in the service.
Report 22511 for one treated body whether cement is injected through unilateral or bilateral access; modifier 50 is inappropriate. Use 22512 for each additional treated body. Documentation should identify the vertebral level, indication, number of bodies treated, and procedure performed, including whether cavity creation was used. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Kentucky compares for 22511
Across 109 of 109 payment localities, the office rate for 22511 runs from $1,545.18 in Arkansas to $2,446.33 in San Benito County, CA. Kentucky pays $1,604.45. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Kentucky · this page$1,604.45
- Los Angeles, CA · California$2,046.09+$441.64
- Washington, DC area · District of Columbia$2,057.74+$453.29
- Miami, FL · Florida$1,890.04+$285.59
- Chicago, IL · Illinois$1,829.37+$224.92
- Manhattan, NY · New York$2,053.05+$448.60
- Alaska · Alaska$1,974.74+$370.29
Other areas in Kentucky first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $1,570.99 | $335.03 |
| ArkansasArkansas | $1,545.18 | $331.82 |
| ArizonaArizona | $1,722.30 | $353.56 |
| Bakersfield, CACalifornia | $1,908.42 | $360.30 |
| Chico, CACalifornia | $1,905.34 | $357.21 |
| El Centro, CACalifornia | $1,905.52 | $357.39 |
| Fresno, CACalifornia | $1,905.34 | $357.21 |
| Hanford, CACalifornia | $1,905.34 | $357.21 |
| Madera, CACalifornia | $1,905.34 | $357.21 |
| Merced, CACalifornia | $1,905.34 | $357.21 |
| Modesto, CACalifornia | $1,905.34 | $357.21 |
| Napa, CACalifornia | $2,248.18 | $386.48 |
| Oxnard, CACalifornia | $2,040.02 | $370.42 |
| Redding, CACalifornia | $1,905.34 | $357.21 |
| Rest of CaliforniaCalifornia | $1,905.34 | $357.21 |
| Riverside, CACalifornia | $1,916.91 | $368.78 |
| Sacramento, CACalifornia | $2,010.33 | $367.57 |
| Salinas, CACalifornia | $2,003.14 | $366.03 |
| San Diego, CACalifornia | $2,058.59 | $369.21 |
| Marin County, CACalifornia | $2,392.01 | $400.36 |
| San Francisco, CACalifornia | $2,390.80 | $399.14 |
| San Benito County, CACalifornia | $2,446.33 | $409.47 |
| Santa Clara County, CACalifornia | $2,441.36 | $404.50 |
| San Luis Obispo, CACalifornia | $1,969.81 | $360.95 |
| Santa Cruz, CACalifornia | $2,084.72 | $368.50 |
| Santa Maria, CACalifornia | $2,012.92 | $365.92 |
| Santa Rosa, CACalifornia | $2,106.36 | $371.78 |
| Stockton, CACalifornia | $1,905.34 | $357.21 |
| Vallejo, CACalifornia | $2,246.43 | $384.72 |
| Visalia, CACalifornia | $1,905.34 | $357.21 |
| Yuba City, CACalifornia | $1,905.34 | $357.21 |
| ColoradoColorado | $1,864.92 | $361.99 |
| ConnecticutConnecticut | $1,901.65 | $380.37 |
| DelawareDelaware | $1,753.51 | $357.94 |
| Fort Lauderdale, FLFlorida | $1,822.29 | $391.40 |
| Rest of FloridaFlorida | $1,725.93 | $375.55 |
| Atlanta, GAGeorgia | $1,805.81 | $370.69 |
| Rest of GeorgiaGeorgia | $1,618.85 | $358.88 |
| Hawaii, Guam, HIHawaii | $1,964.29 | $358.25 |
| IowaIowa | $1,624.93 | $332.47 |
| IdahoIdaho | $1,635.14 | $335.62 |
| East St. Louis, ILIllinois | $1,690.21 | $390.69 |
| Rest of IllinoisIllinois | $1,663.60 | $373.96 |
| Suburban Chicago, ILIllinois | $1,843.67 | $393.00 |
| IndianaIndiana | $1,646.10 | $336.69 |
| KansasKansas | $1,612.26 | $335.33 |
| New Orleans, LALouisiana | $1,690.32 | $361.13 |
| Rest of LouisianaLouisiana | $1,599.99 | $349.91 |
| Metropolitan Boston, MAMassachusetts | $2,070.66 | $384.11 |
| Rest of MassachusettsMassachusetts | $1,849.95 | $362.57 |
| Baltimore area, MDMaryland | $1,895.67 | $380.03 |
| Rest of MarylandMaryland | $1,791.37 | $361.90 |
| Rest of MaineMaine | $1,640.46 | $340.94 |
| Southern Maine, MEMaine | $1,747.24 | $347.43 |
| Detroit, MIMichigan | $1,745.96 | $382.88 |
| Rest of MichiganMichigan | $1,648.09 | $358.45 |
| MinnesotaMinnesota | $1,792.24 | $338.76 |
| Metropolitan Kansas City, MOMissouri | $1,681.64 | $355.28 |
| Metropolitan St. Louis, MOMissouri | $1,702.02 | $357.30 |
| Rest of MissouriMissouri | $1,566.08 | $348.48 |
| MississippiMississippi | $1,556.18 | $340.00 |
| MontanaMontana | $1,773.85 | $361.33 |
| North CarolinaNorth Carolina | $1,660.56 | $342.68 |
| North DakotaNorth Dakota | $1,752.69 | $340.17 |
| NebraskaNebraska | $1,636.24 | $332.48 |
| New HampshireNew Hampshire | $1,830.93 | $360.49 |
| Northern New JerseyNew Jersey | $2,031.30 | $392.77 |
| Rest of New JerseyNew Jersey | $1,924.88 | $382.41 |
| New MexicoNew Mexico | $1,656.66 | $361.37 |
| NevadaNevada | $1,769.45 | $355.52 |
| NYC suburbs and Long Island, NYNew York | $2,103.21 | $423.72 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,934.61 | $387.90 |
| Queens, NYNew York | $2,077.89 | $408.28 |
| Rest of New YorkNew York | $1,688.34 | $346.44 |
| OhioOhio | $1,643.76 | $354.13 |
| OklahomaOklahoma | $1,605.52 | $344.14 |
| Portland, OROregon | $1,935.02 | $365.71 |
| Rest of OregonOregon | $1,757.31 | $350.44 |
| Metropolitan Philadelphia, PAPennsylvania | $1,846.59 | $376.15 |
| Rest of PennsylvaniaPennsylvania | $1,649.01 | $352.31 |
| Puerto RicoPuerto Rico | $1,789.88 | $361.82 |
| Rhode IslandRhode Island | $1,824.08 | $364.94 |
| South CarolinaSouth Carolina | $1,654.61 | $349.44 |
| South DakotaSouth Dakota | $1,750.19 | $337.67 |
| TennesseeTennessee | $1,620.93 | $336.95 |
| Austin, TXTexas | $1,857.29 | $362.84 |
| Beaumont, TXTexas | $1,636.44 | $351.04 |
| Brazoria, TXTexas | $1,754.48 | $354.66 |
| Dallas, TXTexas | $1,765.00 | $358.12 |
| Fort Worth, TXTexas | $1,750.47 | $357.72 |
| Galveston, TXTexas | $1,759.19 | $356.55 |
| Houston, TXTexas | $1,778.77 | $376.14 |
| Rest of TexasTexas | $1,693.99 | $353.50 |
| UtahUtah | $1,680.31 | $352.54 |
| VirginiaVirginia | $1,737.93 | $349.41 |
| Virgin Islands, VIUnited States Virgin Islands | $1,789.88 | $361.82 |
| VermontVermont | $1,741.27 | $342.87 |
| Rest of WashingtonWashington | $1,847.95 | $360.56 |
| King County, WAWashington | $2,119.68 | $386.51 |
| WisconsinWisconsin | $1,686.22 | $333.02 |
| West VirginiaWest Virginia | $1,592.91 | $365.42 |
| WyomingWyoming | $1,764.63 | $352.11 |
22511 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$1,545.18
$2,175.84
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,974.74 | 1 |
| AL | $1,570.99 | 1 |
| AR | $1,545.18 | 1 |
| AZ | $1,722.30 | 1 |
| CA | $1,905.34–$2,446.33 | 29 |
| CO | $1,864.92 | 1 |
| CT | $1,901.65 | 1 |
| DC | $2,057.74 | 1 |
| DE | $1,753.51 | 1 |
| FL | $1,725.93–$1,890.04 | 3 |
| GA | $1,618.85–$1,805.81 | 2 |
| GU | $1,964.29 | 1 |
| HI | $1,964.29 | 1 |
| IA | $1,624.93 | 1 |
| ID | $1,635.14 | 1 |
| IL | $1,663.60–$1,843.67 | 4 |
| IN | $1,646.10 | 1 |
| KS | $1,612.26 | 1 |
| KY | $1,604.45 | 1 |
| LA | $1,599.99–$1,690.32 | 2 |
| MA | $1,849.95–$2,070.66 | 2 |
| MD | $1,791.37–$2,057.74 | 3 |
| ME | $1,640.46–$1,747.24 | 2 |
| MI | $1,648.09–$1,745.96 | 2 |
| MN | $1,792.24 | 1 |
| MO | $1,566.08–$1,702.02 | 3 |
| MS | $1,556.18 | 1 |
| MT | $1,773.85 | 1 |
| NC | $1,660.56 | 1 |
| ND | $1,752.69 | 1 |
| NE | $1,636.24 | 1 |
| NH | $1,830.93 | 1 |
| NJ | $1,924.88–$2,031.30 | 2 |
| NM | $1,656.66 | 1 |
| NV | $1,769.45 | 1 |
| NY | $1,688.34–$2,103.21 | 5 |
| OH | $1,643.76 | 1 |
| OK | $1,605.52 | 1 |
| OR | $1,757.31–$1,935.02 | 2 |
| PA | $1,649.01–$1,846.59 | 2 |
| PR | $1,789.88 | 1 |
| RI | $1,824.08 | 1 |
| SC | $1,654.61 | 1 |
| SD | $1,750.19 | 1 |
| TN | $1,620.93 | 1 |
| TX | $1,636.44–$1,857.29 | 8 |
| UT | $1,680.31 | 1 |
| VA | $1,737.93–$2,057.74 | 2 |
| VI | $1,789.88 | 1 |
| VT | $1,741.27 | 1 |
| WA | $1,847.95–$2,119.68 | 2 |
| WI | $1,686.22 | 1 |
| WV | $1,592.91 | 1 |
| WY | $1,764.63 | 1 |
How the 22511 rate is calculated
Each of 22511’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 22511
RVUs × geographic indexes × conversion factor
Work7.15
7.15 RVUs× 1.000 GPCI
Practice expense44.89
44.89 RVUs× 1.000 GPCI
Malpractice1.07
1.07 RVUs× 1.000 GPCI
Adjusted RVUs
53.1100
Conversion factor
$33.4009
Medicare rate
$1,773.92
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Kentucky inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,072
- Code
- 22511
- Physician work
- 7.15
- Practice expense
- 44.89
- Malpractice
- 1.07
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.15 | × 1.000 | 7.1500 |
| Practice expense | 44.89 | × 0.889 | 39.9072 |
| Malpractice | 1.07 | × 0.915 | 0.9791 |
| Total RVUs | 48.0363 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Kentucky$1604.45
Office: (7.15 × 1 + 44.89 × 0.889 + 1.07 × 0.915) × $33.4009 = $1604.45
Facility: (7.15 × 1 + 2.6 × 0.889 + 1.07 × 0.915) × $33.4009 = $348.72
Payment rules and modifiers for 22511
22511 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22511
Vertebroplasty, lumbosacral, one vertebral body
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22511
Vertebroplasty, lumbosacral, one vertebral body
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22511 without 51 · national office
$1,773.92
Vertebroplasty, lumbosacral, one vertebral body
22511-51 · Second procedure: 50%
$886.96
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 22511 has changed in Kentucky
22511 · Office / nonfacility
$1604.45
Effective 2026-10-01
The base rate is $103.77 higher than on 2025-10-01, moving from $1500.68 to $1604.45 (6.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$1500.68changed to$1604.45
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 7.33 changed to 7.15
- Practice expense RVU 43.46 changed to 44.89
- Malpractice RVU 1.04 changed to 1.07
- Practice expense GPCI 0.877 changed to 0.889
- Malpractice GPCI 0.913 changed to 0.915
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1588.46changed to$1500.68
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 44.94 changed to 43.46
- Malpractice RVU 1.07 changed to 1.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1562.53changed to$1588.46
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1647.59changed to$1562.53
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 46.28 changed to 44.94
- Malpractice RVU 1.02 changed to 1.07
- Practice expense GPCI 0.873 changed to 0.877
- Malpractice GPCI 0.870 changed to 0.913
January 1, 2023
RVU23A
$1717.41changed to$1647.59
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 47.76 changed to 46.28
- Malpractice RVU 0.96 changed to 1.02
- Practice expense GPCI 0.869 changed to 0.873
- Malpractice GPCI 0.827 changed to 0.870
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1736.26changed to$1717.41
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 47.95 changed to 47.76
- Malpractice RVU 0.92 changed to 0.96
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1653.04changed to$1736.26
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 43.22 changed to 47.95
- Malpractice RVU 0.85 changed to 0.92
- Practice expense GPCI 0.874 changed to 0.869
- Malpractice GPCI 0.823 changed to 0.827
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1594.22changed to$1653.04
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 41.11 changed to 43.22
- Malpractice RVU 0.89 changed to 0.85
- Practice expense GPCI 0.880 changed to 0.874
- Malpractice GPCI 0.819 changed to 0.823
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1530.71changed to$1594.22
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 39.17 changed to 41.11
- Malpractice RVU 0.88 changed to 0.89
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$1518.40changed to$1530.71
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 39.11 changed to 39.17
- Malpractice RVU 0.89 changed to 0.88
- Practice expense GPCI 0.876 changed to 0.880
- Malpractice GPCI 0.807 changed to 0.819
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1589.16changed to$1518.40
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 7.58 changed to 7.33
- Practice expense RVU 41.35 changed to 39.11
- Malpractice RVU 0.94 changed to 0.89
- Practice expense GPCI 0.872 changed to 0.876
- Malpractice GPCI 0.795 changed to 0.807
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1587.83changed to$1589.16
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 41.07 changed to 41.35
- Malpractice RVU 1.00 changed to 0.94
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$1579.93changed to$1587.83
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$1579.93
Held through RVU15B.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,604.45 | $348.72 | RVU26D |
| 2026-07-01 | $1,604.45 | $348.72 | RVU26C |
| 2026-04-01 | $1,604.45 | $348.72 | RVU26B |
| 2026-01-01 | $1,604.45 | $348.72 | RVU26A |
| 2025-10-01 | $1,500.68 | $375.61 | RVU25D |
| 2025-07-01 | $1,500.68 | $375.61 | RVU25C |
| 2025-04-01 | $1,500.68 | $375.61 | RVU25B |
| 2025-01-01 | $1,500.68 | $375.61 | RVU25A |
| 2024-10-01 | $1,588.46 | $383.95 | RVU24D |
| 2024-07-01 | $1,588.46 | $383.95 | RVU24C |
| 2024-04-01 | $1,588.46 | $383.95 | RVU24B |
| 2024-03-09 | $1,588.46 | $383.95 | RVU24AR |
| 2024-01-01 | $1,562.53 | $377.68 | RVU24A |
| 2023-10-01 | $1,647.59 | $387.33 | RVU23D |
| 2023-07-01 | $1,647.59 | $387.33 | RVU23C |
| 2023-04-01 | $1,647.59 | $387.33 | RVU23B |
| 2023-01-01 | $1,647.59 | $387.33 | RVU23A |
| 2022-10-01 | $1,717.41 | $390.30 | RVU22D |
| 2022-07-01 | $1,717.41 | $390.30 | RVU22C |
| 2022-04-01 | $1,717.41 | $390.30 | RVU22B |
| 2022-01-01 | $1,717.41 | $390.30 | RVU22A |
| 2021-10-01 | $1,736.26 | $390.87 | RVU21D |
| 2021-07-01 | $1,736.26 | $390.87 | RVU21C |
| 2021-04-01 | $1,736.26 | $390.87 | RVU21B |
| 2021-01-01 | $1,736.26 | $390.87 | RVU21A |
| 2020-10-01 | $1,653.04 | $401.44 | RVU20D |
| 2020-07-01 | $1,653.04 | $401.44 | RVU20C |
| 2020-04-01 | $1,653.04 | $401.44 | RVU20B |
| 2020-01-01 | $1,653.04 | $401.44 | RVU20A |
| 2019-10-01 | $1,594.22 | $402.70 | RVU19D |
| 2019-07-01 | $1,594.22 | $402.70 | RVU19C |
| 2019-04-01 | $1,594.22 | $402.70 | RVU19B |
| 2019-01-01 | $1,594.22 | $402.70 | RVU19A |
| 2018-10-01 | $1,530.71 | $402.60 | RVU18D |
| 2018-07-01 | $1,530.71 | $402.60 | RVU18C |
| 2018-04-01 | $1,530.71 | $402.60 | RVU18B |
| 2018-01-01 | $1,530.71 | $402.60 | RVU18AR1 |
| 2017-10-01 | $1,518.40 | $402.96 | RVU17D |
| 2017-07-01 | $1,518.40 | $402.96 | RVU17C |
| 2017-04-01 | $1,518.40 | $402.96 | RVU17B |
| 2017-01-01 | $1,518.40 | $402.96 | RVU17A |
| 2016-10-01 | $1,589.16 | $415.86 | RVU16D |
| 2016-07-01 | $1,589.16 | $415.86 | RVU16C |
| 2016-04-01 | $1,589.16 | $415.86 | RVU16B |
| 2016-01-01 | $1,589.16 | $415.86 | RVU16A |
| 2015-10-01 | $1,587.83 | $418.13 | RVU15D |
| 2015-07-01 | $1,587.83 | $418.13 | RVU15C |
| 2015-04-01 | $1,579.93 | $416.05 | RVU15B |
| 2015-01-01 | $1,579.93 | $416.05 | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Kentucky rate applies
Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.
- Adairville
- Ages
- Albany
- Alexandria
- Allen
- Allensville
- Anchorage
- Annville
22511 billing questions
When should 22511 be chosen instead of 22514?
Use 22511 for lumbosacral vertebroplasty without mechanical cavity creation. Code 22514 describes lumbar vertebral augmentation that uses cavity creation.
Can 22511 be reported with modifier 50?
No. The code covers treatment of one vertebral body with unilateral or bilateral injection, and a bilateral adjustment is inappropriate.
How is an additional treated vertebral body reported?
Report 22512 for each additional vertebral body treated in the same session, following the primary 22511 service.
Is a bone biopsy performed during vertebroplasty separately reported?
A bone biopsy performed during 22511 is included in the service.
What documentation supports 22511?
Document the lumbosacral vertebral level, clinical indication, number of bodies treated, and whether the procedure involved mechanical cavity creation.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in 22511.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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