This is a patient demand report for spine practice owners and marketing leads. It shows what patients pay for kyphoplasty and vertebroplasty, what Medicare pays your practice, what the evidence says, and what patients find when they search before they call. The practice-side facts come first; the patient detail below is the evidence behind them.
For practice owners: what this search looks like from your side
Some facts, side by side.
In fee-for-service Medicare, vertebroplasty episodes fell 66% from 2009 to 2018, from 27,380 to 9,240. Kyphoplasty episodes were 49,480 in 2009 and 49,520 in 2018. (Pain Physician, 2021)
For 2026, Medicare’s national average for a thoracic kyphoplasty done in your office is $5,805. Done in a facility, the surgeon fee you bill is $453 and the facility is paid separately. For vertebroplasty the office figure is $1,764.
The pages ranking for this comparison are mostly journal studies built on 2006 to 2009 data and price sites that do not explain their numbers.
In the KAVIAR trial, the average patient was 75.6 years old and 77.4% were women.
What those mean together for your practice is for you to work out. If you advertise these procedures, my page on Google Ads costs for spine surgeons covers the paid side.
If you want to see how your spine pages answer the cost question today, book a 30-minute call. I will look at your site and your market before we talk. You can also read what a page like this is worth to an orthopedic practice.
What patients pay
When I reviewed the pages that rank for this comparison, they were mostly journal studies whose cost data come from 2006 to 2009, price-comparison sites listing averages without saying where they came from, and medical-tourism pages from hospitals abroad. None put current Medicare rates, published prices and the trial evidence for both procedures on one page.
Patients are comparing two ways of treating a vertebral compression fracture. Both are done through a needle, usually under imaging, and both leave bone cement inside the broken vertebra. Vertebroplasty injects the cement directly. Kyphoplasty, which CPT calls percutaneous vertebral augmentation, first uses a mechanical device such as an inflatable balloon or tamp to create a cavity, then fills it. CPT treats that device step as what separates the two, and it is billed under codes that pay more. (Medtronic balloon kyphoplasty 2026 coding and payment guide)
Here is what patients come across.
| Vertebroplasty | Kyphoplasty | |
|---|---|---|
| Mean hospital cost, outpatient, 2007 to 2008 | $3,319 | $8,100 |
| Mean hospital cost, inpatient, 2007 to 2008 | $9,837 | $13,187 |
| Price-comparison site national average | $7,327 | $18,320 |
The hospital cost rows come from a study of 3,617 vertebroplasty and 8,118 kyphoplasty patients in a large US hospital database. The authors put most of the gap down to supplies and operating room time. (AJNR, 2011)
The last row is from New Choice Health, which does not say how or when its averages of $7,327 and $18,320 were calculated. (vertebroplasty, kyphoplasty) On MDsave, a site where patients prepay a set price, kyphoplasty listings ranged from $7,544 to $17,367 when I checked on 1 October 2026. (MDsave)
Cost over two years, not just the day. Up front, vertebroplasty is the cheaper procedure in every dataset above. One ranking study followed the money further. Using a 5% sample of Medicare patients treated from 2006 to 2009, researchers tracked 1,609 vertebroplasty and 2,878 kyphoplasty patients for two years. Average adjusted costs were $44,496 after vertebroplasty and $41,339 after kyphoplasty. There was no significant difference for the first nine months, then kyphoplasty patients cost 6.8% to 7.9% less. The authors linked this to more use of medical care after vertebroplasty. (Osteoporosis International, 2013) It is one observational study, and the groups were not randomized, so it cannot show the procedure caused the difference.
What Medicare pays your practice
Medicare pays the facility and the surgeon separately, so the two figures add together. The codes already include imaging guidance during the procedure.
| Vertebroplasty | Kyphoplasty | |
|---|---|---|
| Procedure codes, first level | CPT 22510 (cervicothoracic), 22511 (lumbosacral) | CPT 22513 (thoracic), 22514 (lumbar) |
| Each additional level | +22512 | +22515 |
| Medicare 2026, hospital outpatient facility, one level | $3,343 | $7,413 |
| Medicare 2026, surgery center facility, one level | $1,645 | $3,696 |
| Medicare 2026, surgeon fee in a facility, first level | $383 (22510) | $453 (22513) |
| Medicare 2026, performed in an office, first level | $1,764 (22510) | $5,805 (22513) |
Codes and 2026 Medicare rates come from Medtronic’s 2026 coding guides for vertebroplasty and balloon kyphoplasty, which cite the CMS 2026 final rules. Medtronic sells equipment for both procedures.
Adding the two sides for one level in a hospital outpatient department gives about $7,866 for kyphoplasty ($7,413 plus $453) and $3,726 for vertebroplasty ($3,343 plus $383). In a surgery center the same sums are $4,149 and $2,028.
Two quirks matter for your billing. Treating more than one level moves the hospital payment up a tier: multi-level vertebroplasty pays $7,413, the same as single-level kyphoplasty, and multi-level kyphoplasty pays $13,117. And when a patient is admitted to hospital, the stay is paid as a diagnosis group, not as an outpatient procedure. For kyphoplasty to treat a fracture caused by osteoporosis or cancer, with no complications or comorbidities, that national average is $11,182.
These are national averages before local adjustments. A Medicare patient owes a share of these amounts, set by their deductible and coinsurance, and it moves with the setting.
What the evidence patients read says
This is where the comparison is contested, and patients who research it find both sides.
Vertebroplasty against a sham procedure. In 2009, two sham-controlled trials found no significant benefit. One randomized 78 people and found no advantage at any point up to six months. (NEJM, 2009) The other, the Investigational Vertebroplasty Efficacy and Safety Trial (INVEST), randomized 131 patients and found no significant difference at one month, with a trend toward more people reaching meaningful pain relief after vertebroplasty, 64% against 48%. (NEJM, 2009) The Dutch VERTOS IV trial of 180 patients with recent fractures also found no significant difference from sham over 12 months. (BMJ, 2018)
Vertebroplasty against usual care. The open-label VERTOS II trial randomized 202 patients whose back pain had lasted six weeks or less and reported 2.6 points more pain relief on a 10-point scale at one month and 2.0 points more at one year. Patients and assessors knew who had the procedure. (Lancet, 2010)
The Cochrane review. The 2018 Cochrane review included 21 trials. From the five sham-controlled ones, it found high to moderate quality evidence that vertebroplasty gives no clinically important benefit over sham. Pain was 0.7 points better on a 10-point scale, an absolute difference of 7%, below the 15% the authors treat as the smallest change patients notice. It also concluded open trials likely overestimate the benefit. (Cochrane, 2018)
Kyphoplasty against usual care. The FREE trial randomized 300 patients at 21 sites in eight countries. At one month, the SF-36 physical component score improved 5.2 points more with kyphoplasty than with non-surgical care. (Lancet, 2009) At two years, back pain remained significantly lower, while the function score difference was no longer significant at 12 or 24 months. (Journal of Bone and Mineral Research, 2011) FREE did not use a sham procedure.
Kyphoplasty against vertebroplasty. The KAVIAR trial (ClinicalTrials.gov NCT00323609) treated 381 patients and stopped early because of low enrollment. Pain and function improved similarly, kyphoplasty took longer (40.0 against 31.8 minutes) and had less cement leakage on CT. (AJNR, 2014) A 2025 meta-analysis of 11 trials and 1,190 patients found no difference in pain or cement leakage, with better spinal angle correction after kyphoplasty. (Journal of Bone and Joint Surgery, 2025)
Survival. In more than a million Medicare patients with these fractures, those who had no procedure had a 55% higher adjusted risk of death than kyphoplasty patients and 25% higher than vertebroplasty patients. (Spine, 2015) That study is observational, so healthier patients may simply have been the ones offered a procedure.
Who patients are
Patients searching this have a vertebral compression fracture, a collapse of one of the bones of the spine. It usually comes from osteoporosis and sometimes from cancer in the spine. In the KAVIAR trial they averaged 75.6 years old and 77.4% were women.
Many of these fractures settle on their own. In VERTOS II, 229 of 431 eligible patients, 53%, had their pain resolve during assessment before anyone was randomized. (Lancet, 2010) Which patients are offered either procedure depends on how old the fracture is, what MRI shows and their overall health.
Questions patients ask before they book
These are the questions your page and your front desk need to answer.
- Has the patient’s fracture had time to settle without a procedure? A good page explains how the practice judges fracture age and links the VERTOS II finding.
- Why kyphoplasty or vertebroplasty, and what does the evidence say? A good page states which the practice offers and links the sham trials next to the open ones.
- Where will it happen? A good page names the setting, because setting moves the bill more than anything else.
- What will the patient owe in total? A good page splits facility, surgeon, anesthesia and imaging.
- What happens with the patient’s bone health afterwards? A compression fracture is often a sign of osteoporosis, so a good page says what follow-up the practice provides.
Back pain has other common treatments with their own costs. My pages on epidural steroid injection cost, spinal cord stimulator cost and lumbar fusion surgery cost show what patients find for each.
What a page that wins this search includes
- Both procedures priced side by side, facility and surgeon split, which no ranking page does today.
- A posted cash or bundled price, or a plain explanation of why kyphoplasty bills more: the cavity step, supplies and operating room time.
- Medicare, commercial and self-pay explained separately, by setting.
- The sham and open trials linked, stated neutrally and left disputed.
- The practice’s own annual volume of each procedure.
Frequently asked questions
Is kyphoplasty more expensive than vertebroplasty? Up front, yes. Medicare’s 2026 national average hospital outpatient rate is $7,413 for kyphoplasty and $3,343 for vertebroplasty, and hospital cost studies show the same pattern.
Does Medicare cover kyphoplasty and vertebroplasty? Both have Medicare payment rates for 2026 in hospitals, surgery centers and offices. Coverage for an individual patient depends on meeting the medical criteria their Medicare contractor applies.
Which works better, kyphoplasty or vertebroplasty? In head-to-head trials pain relief was similar. Kyphoplasty showed less cement leakage in one trial and better angle correction in a 2025 meta-analysis.
Does vertebroplasty actually work? The evidence is disputed. Sham-controlled trials and the 2018 Cochrane review found no clinically important benefit over placebo, while open trials against usual care reported more pain relief.
Why does the price vary so much? Setting matters most. Medicare pays a surgery center about half what it pays a hospital outpatient department for the same procedure, and cash prices listed online vary more than twofold.
