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CPT code 22513: Vertebral augmentation, thoracic, initial vertebral body2026 Medicare rate & RVUs in Connecticut

Percutaneous thoracic vertebral augmentation stabilizes a painful compression fracture through cavity creation and cement placement, reported for the first treated vertebral body.

CMS RVU26DEffective Oct 1, 2026One payment locality19.1K Medicare services in 2024

In Connecticut, Medicare pays $6,238.68 for 22513 in the office and $479.44 when it’s performed in a hospital or facility.

$6,238.68Office (non-facility)
$479.44Hospital or facility
+7.5%vs the national office rate ($5,801.07)

Check a contract rate as a % of Medicare · 22513 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 22513 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 22513 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 22513 covers

This image-guided procedure treats a painful fracture in a thoracic vertebral body, commonly from osteoporosis or a tumor-related weakened vertebra. The physician accesses the vertebra through the skin, creates a cavity within the bone, and places bone cement to stabilize it. Interventional radiologists and spine surgeons commonly perform the procedure in a hospital or ambulatory setting. Imaging guidance is included in the service.

Report 22513 for the first thoracic vertebral body treated. A separate add-on code is used for each additional treated body; the operative report should identify the levels, access, cavity creation, and cement placement. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Do not append modifier 50; the code accommodates unilateral or bilateral cannulation. Medicare does not pay an assistant at surgery, and co-surgeon or team-surgery reporting is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Connecticut compares for 22513

Across 109 of 109 payment localities, the office rate for 22513 runs from $5,004.78 in Arkansas to $8,224.15 in San Benito County, CA. Connecticut pays $6,238.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

22513 in Connecticut vs other payment areas
  1. Connecticut · this page$6,238.68
  2. Los Angeles, CA · California$6,795.46+$556.78
  3. Washington, DC area · District of Columbia$6,795.34+$556.66
  4. Miami, FL · Florida$6,105.40−$133.28
  5. Chicago, IL · Illinois$5,898.28−$340.40
  6. Manhattan, NY · New York$6,735.48+$496.80
  7. Alaska · Alaska$6,273.67+$34.99

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

22513 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$5,094.93$415.88
ArkansasArkansas$5,004.78$411.29
ArizonaArizona$5,624.04$442.33
Bakersfield, CACalifornia$6,310.75$449.91
Chico, CACalifornia$6,306.36$445.52
El Centro, CACalifornia$6,306.62$445.78
Fresno, CACalifornia$6,306.36$445.52
Hanford, CACalifornia$6,306.36$445.52

22513 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$5,004.78

$7,265.25

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
22513 office rate range by state
State / territoryOffice rate rangeLocalities
AK$6,273.671
AL$5,094.931
AR$5,004.781
AZ$5,624.041
CA$6,306.36–$8,224.1529
CO$6,142.851
CT$6,238.681
DC$6,795.341
DE$5,731.581
FL$5,586.89–$6,105.403
GA$5,220.69–$5,899.932
GU$6,527.981
HI$6,527.981
IA$5,304.751
ID$5,336.071
IL$5,354.96–$5,991.134
IN$5,375.021
KS$5,250.221
KY$5,189.771
LA$5,170.15–$5,485.642
MA$6,084.68–$6,867.452
MD$5,865.19–$6,795.343
ME$5,343.88–$5,732.512
MI$5,332.20–$5,645.692
MN$5,922.701
MO$5,045.25–$5,538.753
MS$5,027.461
MT$5,800.961
NC$5,415.841
ND$5,769.921
NE$5,347.491
NH$6,018.661
NJ$6,320.39–$6,697.102
NM$5,357.841
NV$5,797.781
NY$5,512.14–$6,897.305
OH$5,325.851
OK$5,204.401
OR$5,763.63–$6,398.992
PA$5,349.89–$6,040.412
PR$5,860.421
RI$5,981.171
SC$5,377.711
SD$5,766.251
TN$5,279.291
TX$5,305.31–$6,112.748
UT$5,467.701
VA$5,692.71–$6,795.342
VI$5,860.421
VT$5,720.491
WA$6,081.95–$7,046.572
WI$5,535.161
WV$5,107.481
WY$5,787.431

See 22513 in every payment locality

How the 22513 rate is calculated

Each of 22513’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 22513

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.43

8.43 RVUs× 1.000 GPCI

Practice expense163.68

163.68 RVUs× 1.000 GPCI

Malpractice1.57

1.57 RVUs× 1.000 GPCI

Adjusted RVUs

173.6800

Conversion factor

$33.4009

Medicare rate

$5,801.07

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,074

Code
22513
Physician work
8.43
Practice expense
163.68
Malpractice
1.57

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 22513 in Connecticut
ComponentRVULocality factorAdjusted
Physician work8.43× 1.0208.5986
Practice expense163.68× 1.077176.2834
Malpractice1.57× 1.2101.8997
Total RVUs186.7817
Conversion factor× 33.4009

Office rate, Connecticut$6238.68

Office: (8.43 × 1.02 + 163.68 × 1.077 + 1.57 × 1.21) × $33.4009 = $6238.68

Facility: (8.43 × 1.02 + 3.58 × 1.077 + 1.57 × 1.21) × $33.4009 = $479.44

Open 22513 in the RVU calculator

Payment rules and modifiers for 22513

22513 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22513

Vertebral augmentation, thoracic, initial vertebral body

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22513

Vertebral augmentation, thoracic, initial vertebral body

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

22513 without 51 · national office

$5,801.07

Vertebral augmentation, thoracic, initial vertebral body

22513-51 · Second procedure: 50%

$2,900.54

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 22513

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 22513
CodeHow it relatesOffice range, Connecticut
Same family
22514Vertebral augmentation, lumbar, one vertebral bodyInitial vertebral augmentation code for a lumbar rather than thoracic body.$6,244.35
Add-on codes
22515Vertebral augmentation, each additional thoracic or lumbar bodyAdd-on for each additional vertebral body treated after the initial augmentation.$3,203.06
Used instead
22510Vertebroplasty, cervicothoracic vertebral bodyPercutaneous vertebroplasty by injection for a cervicothoracic body, rather than thoracic cavity-creating augmentation.$1,889.50

How 22513 has changed in Connecticut

22513 · Office / nonfacility

$6238.68

Effective 2026-10-01

The base rate is $571.77 higher than on 2025-10-01, moving from $5666.91 to $6238.68 (10.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $5666.91changed to$6238.68

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.65 changed to 8.43
    • Practice expense RVU 150.73 changed to 163.68
    • Malpractice RVU 1.58 changed to 1.57
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $6098.52changed to$5666.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 158.02 changed to 150.73
    • Malpractice RVU 1.63 changed to 1.58

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $5998.98changed to$6098.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $6467.12changed to$5998.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 163.54 changed to 158.02
    • Malpractice RVU 1.60 changed to 1.63
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $6889.18changed to$6467.12

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 169.35 changed to 163.54
    • Malpractice RVU 1.55 changed to 1.60
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $7559.42changed to$6889.18

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 185.14 changed to 169.35
    • Malpractice RVU 1.53 changed to 1.55

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $7570.49changed to$7559.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 179.02 changed to 185.14
    • Malpractice RVU 1.48 changed to 1.53
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $7816.59changed to$7570.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 185.31 changed to 179.02
    • Malpractice RVU 1.59 changed to 1.48
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $8128.77changed to$7816.59

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 193.30 changed to 185.31
    • Malpractice RVU 1.61 changed to 1.59

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $8143.35changed to$8128.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 193.39 changed to 193.30
    • Malpractice RVU 1.64 changed to 1.61
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $8350.83changed to$8143.35

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 8.90 changed to 8.65
    • Practice expense RVU 198.04 changed to 193.39
    • Malpractice RVU 1.72 changed to 1.64
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $8379.23changed to$8350.83

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 197.92 changed to 198.04
    • Malpractice RVU 1.79 changed to 1.72

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $8337.54changed to$8379.23

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    No ratechanged to$8337.54

    Held through RVU15B.

  15. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$6,238.68$479.44RVU26D
2026-07-01$6,238.68$479.44RVU26C
2026-04-01$6,238.68$479.44RVU26B
2026-01-01$6,238.68$479.44RVU26A
2025-10-01$5,666.91$524.80RVU25D
2025-07-01$5,666.91$524.80RVU25C
2025-04-01$5,666.91$524.80RVU25B
2025-01-01$5,666.91$524.80RVU25A
2024-10-01$6,098.52$538.80RVU24D
2024-07-01$6,098.52$538.80RVU24C
2024-04-01$6,098.52$538.80RVU24B
2024-03-09$6,098.52$538.80RVU24AR
2024-01-01$5,998.98$530.01RVU24A
2023-10-01$6,467.12$542.92RVU23D
2023-07-01$6,467.12$542.92RVU23C
2023-04-01$6,467.12$542.92RVU23B
2023-01-01$6,467.12$542.92RVU23A
2022-10-01$6,889.18$545.95RVU22D
2022-07-01$6,889.18$545.95RVU22C
2022-04-01$6,889.18$545.95RVU22B
2022-01-01$6,889.18$545.95RVU22A
2021-10-01$7,559.42$549.82RVU21D
2021-07-01$7,559.42$549.82RVU21C
2021-04-01$7,559.42$549.82RVU21B
2021-01-01$7,559.42$549.82RVU21A
2020-10-01$7,570.49$568.45RVU20D
2020-07-01$7,570.49$568.45RVU20C
2020-04-01$7,570.49$568.45RVU20B
2020-01-01$7,570.49$568.45RVU20A
2019-10-01$7,816.59$579.36RVU19D
2019-07-01$7,816.59$579.36RVU19C
2019-04-01$7,816.59$579.36RVU19B
2019-01-01$7,816.59$579.36RVU19A
2018-10-01$8,128.77$582.03RVU18D
2018-07-01$8,128.77$582.03RVU18C
2018-04-01$8,128.77$582.03RVU18B
2018-01-01$8,128.77$582.03RVU18AR1
2017-10-01$8,143.35$584.02RVU17D
2017-07-01$8,143.35$584.02RVU17C
2017-04-01$8,143.35$584.02RVU17B
2017-01-01$8,143.35$584.02RVU17A
2016-10-01$8,350.83$602.46RVU16D
2016-07-01$8,350.83$602.46RVU16C
2016-04-01$8,350.83$602.46RVU16B
2016-01-01$8,350.83$602.46RVU16A
2015-10-01$8,379.23$607.33RVU15D
2015-07-01$8,379.23$607.33RVU15C
2015-04-01$8,337.54$604.31RVU15B
2015-01-01$8,337.54$604.31RVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 22513 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

22513 billing questions

How is 22513 different from 22514?

22513 is for thoracic vertebral augmentation; 22514 is the corresponding initial-body code for a lumbar vertebra.

Can 22515 be reported with 22513?

Yes. Use 22515 for each additional vertebral body treated during the same session, following the initial body reported with 22513.

Is imaging guidance separately reported?

Imaging guidance is included in 22513. Do not separately report guidance for the augmentation service.

Should modifier 50 be appended for bilateral access?

No. The service includes unilateral or bilateral cannulation, and modifier 50 is inappropriate.

What documentation supports 22513?

Document the thoracic level treated, the clinical indication, percutaneous access, cavity creation, cement placement, and the imaging used during the procedure.

Are assistant or co-surgeon claims payable?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 22513PPRRVU2026_Oct_nonQPP.csv, line 2,074 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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