CPT 22512 · Vertebral Augmentation · Medicare (CGS MAC)
Vertebroplasty — Each Additional Level at Medicare (CGS MAC).
How Medicare (CGS MAC) approaches CPT 22512 (Vertebroplasty — Each Additional Level) for prior-authorization review: at last review on 2026-05-10, the policy covers this code without prior authorization.
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L35130Criteria summary
High-level themes from the Medicare (CGS MAC) policy of record for CPT 22512. 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 L38201 — Percutaneous Vertebral Augmentation (PVA) for VCF (CGS)
See the full Medicare (CGS MAC) criteria.
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