Does Medicare Cover Kyphoplasty?

About

Medicare 101

Current Clients

Does Medicare Cover Kyphoplasty?

Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo

By Daniel Petkevich

Dec 9, 2022

You're covered if you meet these requirements

Dealing with back pain suffered from a fracture related to osteoporosis can be challenging. A kyphoplasty procedure is an appealing option to those who need more than just medication but don't want to endure major surgery. Medicare covers Kyphoplasty under Part B, but you must meet certain conditions. Let's see what those are below.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

What is Kyphoplasty?

Kyphoplasty, also known as vertebroplasty, is a minimally invasive procedure used to treat painful vertebral fractures that can be caused by osteoporosis or another injury. It involves the insertion of medical balloons into the fractured bone and then filling them with bone cement. With kyphoplasty, most people who get the procedure are sent home the same day. The benefits of kyphoplasty include reduced pain, improved posture, better mobility, and improved quality of life.

How does Medicare cover Kyphoplasty?

In order to be eligible for Medicare coverage, you must meet certain Medicare requirements:

The procedure must be performed in an outpatient hospital setting that is certified by Medicare.
It must be determined to be medically necessary by your doctor or a Medicare-approved provider.
You must have proof of a vertebral fracture (such as an X-ray or MRI).

Talking with your doctor is critical before opting for this procedure. This content is for informational purposes only and does not constitute medical advice.

What are the costs associated with Kyphoplasty?

The cost of kyphoplasty varies depending on the facility and other factors. Medicare will typically cover 80% of the cost, but you may be responsible for any remaining costs or copayments. Be sure to check with your healthcare provider and Medicare before having the procedure done.

How to find a doctor who performs Kyphoplasty procedures?

Before having Kyphoplasty, you'll need to find a qualified healthcare provider who can perform the procedure. You can search online for doctors and hospital listings that specialize in Kyphoplasty procedures and contact them for more information. Be sure to ask about their experience with the procedure, qualifications, and costs. Also, check your Medicare Advantage plan to see if it covers Kyphoplasty.

The risks and side effects of Kyphoplasty

Potential side effects should also be discussed with your doctor prior to the procedure. While Kyphoplasty is generally considered safe, it can cause complications such as infection and nerve damage, so it is important that you understand all of the risks before proceeding.

Takeaway

Kyphoplasty is a minimally invasive procedure that can help reduce pain, improve posture, and improve mobility. Medicare Part B covers Kyphoplasty under certain conditions, but it is important to check with your healthcare provider and Medicare before having the procedure done. This content is for informational purposes only. Call a Fair Square Medicare expert today for all your Medicare-related questions.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

888-454-2383

info@fairsquaremedicare.com

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2026

•

Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2026 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M

Fair Square Medicare

Does Medicare Cover Kyphoplasty?

You're covered if you meet these requirements

Speak with a Medicare Advocate

What is Kyphoplasty?

How does Medicare cover Kyphoplasty?

What are the costs associated with Kyphoplasty?

How to find a doctor who performs Kyphoplasty procedures?

The risks and side effects of Kyphoplasty

Takeaway

Speak with a Medicare Advocate

Recommended Articles

More of our articles

Your Medicare One-Stop-Shop

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans