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See a sample rate comparisonCPT 22511 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Perq Lumbosacral Injection, Percutaneous Vertebroplasty Bone Biopsy Included When Performed 1 Vertebral Body Unilateral Or Bilateral Injection Inclusive Of All Imaging Guidance Lumbosacral
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22511 |
| Medicaid Fee Schedule | View Medicaid rates for 22511 |
National average reimbursement for CPT 22511 by major payers:
$1,964.26
$2,393.79
$2,534.29
$828.65
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CPT 22511
5 of 25 sample ratesHigher to lower in this preview
Carolina Regional Surgery Center. Ltd
Carolina Regional Surgery Center Ltd
$7,186.00Published rateSurgery Center Of Peoria, LLC, Surgery Center Of Peoria
Surgery Center Of Peoria LLC
$3,570.00Published rateKansas Surgery Center, LLC
Kansas Surgery Center LLC
$2,291.00Published rateLahaye Center For Advanced Eye Care, Apmc, Lahaye Eye Clinic
Lahaye Eye Clinic, P.C.
$1,563.00Published rateMaryland Aesthetic And Reconstructive Ambulatory Surgical Center LLC
$512.00Published rate
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See a sample payer proposalCPT 22511 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22511 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 22511 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 22510-CPT | High | Perq Cervicothoracic Inject, Percutaneous Vertebroplasty Bone Biopsy Included When Performed 1 Vertebral Body Unilateral Or Bilateral Injection Inclusive Of All Imaging Guidance Cervicothoracic |
| 22511-CPT | High | Perq Lumbosacral Injection, Percutaneous Vertebroplasty Bone Biopsy Included When Performed 1 Vertebral Body Unilateral Or Bilateral Injection Inclusive Of All Imaging Guidance Lumbosacral |
| 22512-CPT | Moderate | Vertebroplasty Addl Inject, Percutaneous Vertebroplasty Bone Biopsy Included When Performed 1 Vertebral Body Unilateral Or Bilateral Injection Inclusive Of All Imaging Guidance Each Additional Cervicothoracic Or Lumbosacral Vertebral Body List Separately In Addition To Code For Primary Procedure |
| 22513-CPT | High | Perq Vertebral Augmentation, Percutaneous Vertebral Augmentation Including Cavity Creation Fracture Reduction And Bone Biopsy Included When Performed Using Mechanical Device Eg Kyphoplasty 1 Vertebral Body Unilateral Or Bilateral Cannulation Inclusive Of All Imaging Guidance Thoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22511. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22511 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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