Billing code 22511: VertebroplastyMedicare rate & RVUs in Delaware
Percutaneous vertebroplasty places cement in one lumbosacral vertebral body, typically to treat a painful compression fracture without mechanical cavity creation.
Medicare pays $1,753.51 for 22511 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 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.
22511 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $1,753.51 | $357.94 |
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
Swap in your local Medicare rate.
Work 7.15Practice expense 44.89Malpractice 1.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| 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
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
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%).
22511 compared with similar codes
Compare codes
22511 vs 22510 vs 22512 vs 22514: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22510Vertebroplasty
- 22510 is the one-body vertebroplasty code for the cervicothoracic region; 22511 is for the lumbosacral region.
- 22512Vertebroplasty
- 22512 reports each additional vertebral body treated after the primary vertebroplasty, not the first lumbosacral body.
- 22514Vertebral augmentation
- 22514 is for lumbar vertebral augmentation with mechanical cavity creation. Use 22511 when performing lumbosacral vertebroplasty without that method.
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
Show the CMS file lines behind this rate
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