CPT code 22513: Vertebral augmentation, thoracic, initial vertebral body2026 Medicare rate & RVUs in Maine
Percutaneous thoracic vertebral augmentation stabilizes a painful compression fracture through cavity creation and cement placement, reported for the first treated vertebral body.
Medicare pays $5,343.88–$5,732.51 for 22513 in the office in Maine, from Rest of Maine to Southern Maine, ME. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
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.
Where 22513 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $5,343.88 | $424.20 |
| Southern Maine, ME | $5,732.51 | $433.16 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
22513 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22514Vertebral augmentationLumbar, one vertebral body
- Choose 22513 for the initial thoracic vertebral body and 22514 for the initial lumbar body; the treated region determines the code.
- 22515Vertebral augmentationEach additional thoracic or lumbar body
- 22515 is an add-on for an additional treated vertebral body, not the initial body reported with 22513.
- 22510VertebroplastyCervicothoracic vertebral body
- 22510 describes vertebroplasty by cement injection in the cervicothoracic region. 22513 is thoracic augmentation involving cavity creation.
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
Fee sheets · Coming soon
Put 22513 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist