CPT 22511 · Vertebral Augmentation · Medicare (Noridian JF MAC)
Vertebroplasty — Lumbosacral (1st level) at Medicare (Noridian JF MAC).
How Medicare (Noridian JF MAC) approaches CPT 22511 (Vertebroplasty — Lumbosacral (1st level)) for prior-authorization review: at last review on 2025-11-20, the policy covers this code without prior authorization.
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L34228Criteria summary
High-level themes from the Medicare (Noridian JF MAC) policy of record for CPT 22511. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: LCD L34228 — Vertebral Augmentation (Noridian_JE+JF)
See the full Medicare (Noridian JF MAC) criteria.
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