CPT 22514 · Vertebral Augmentation · Medicare (Palmetto GBA MAC) — AL
Kyphoplasty — Lumbar (1st level) at Medicare (Palmetto GBA MAC) — AL.
How Medicare (Palmetto GBA MAC) — AL approaches CPT 22514 (Kyphoplasty — Lumbar (1st level)) for prior-authorization review: at last review on 2026-04-26, the policy covers this code without prior authorization.
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Clearway-MPG-KyphoplastyCriteria summary
High-level themes from the Medicare (Palmetto GBA MAC) — AL policy of record for CPT 22514. 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: Clearway Master Payer Guidelines v2025 — Kyphoplasty
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