Medicare local coverage
Medicare coverage for Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) (LCD)
5 Medicare Administrative Contractors publish a local coverage determination (LCD) for Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF). The snapshot lists 5 LCD records: 5 active.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L38201 | Active | Nov 14, 2025 |
First Coast Service Options, Inc.MAC - Part A, MAC - Part B | L34976 | Active | May 21, 2021 |
Novitas Solutions, Inc.MAC - Part A, MAC - Part B | L35130 | Active | May 21, 2021 |
Palmetto GBAMAC - Part A, MAC - Part B | L38737 | Active | Nov 14, 2025 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L38213 | Active | Jul 24, 2026 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A57282CGS Administrators, LLCUpdated Sep 30, 2025
- A57630WPS Insurance CorporationUpdated Jul 24, 2024
- A57752Novitas Solutions, Inc.Updated Feb 11, 2022
- A57872First Coast Service Options, Inc.Updated Feb 11, 2022
- A58275Palmetto GBAUpdated Jul 1, 2022
CMS also lists 4 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A58462, A58685, A58686, A59138.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Percutaneous Vertebral Augmentation (PVA) for Osteoporotic Vertebral Compression Fracture (VCF)
- Lower Esophageal Magnetic Sphincter Augmentation
- Percutaneous Coronary Intervention
- Percutaneous Coronary Interventions
- Percutaneous minimally invasive fusion/stabilization of the sacroiliac joint for the treatment of back pain
- Thoracic Aortography and Carotid, Vertebral, and Subclavian Angiography
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.