CPT code 22513: Vertebral augmentation, thoracic, initial vertebral body2026 Medicare rate & RVUs in North Dakota
Percutaneous thoracic vertebral augmentation stabilizes a painful compression fracture through cavity creation and cement placement, reported for the first treated vertebral body.
In North Dakota, Medicare pays $5,769.92 for 22513 in the office and $422.44 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How North Dakota 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. North Dakota pays $5,769.92. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$5,769.92
- Los Angeles, CA · California$6,795.46+$1,025.54
- Washington, DC area · District of Columbia$6,795.34+$1,025.42
- Miami, FL · Florida$6,105.40+$335.48
- Chicago, IL · Illinois$5,898.28+$128.36
- Manhattan, NY · New York$6,735.48+$965.56
- Alaska · Alaska$6,273.67+$503.75
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $6,306.36 | $445.52 |
| Merced, CACalifornia | $6,306.36 | $445.52 |
| Modesto, CACalifornia | $6,306.36 | $445.52 |
| Napa, CACalifornia | $7,531.53 | $483.55 |
| Oxnard, CACalifornia | $6,784.19 | $463.46 |
| Redding, CACalifornia | $6,306.36 | $445.52 |
| Rest of CaliforniaCalifornia | $6,306.36 | $445.52 |
| Riverside, CACalifornia | $6,323.27 | $462.42 |
| Sacramento, CACalifornia | $6,678.00 | $458.88 |
| Salinas, CACalifornia | $6,654.73 | $456.99 |
| San Diego, CACalifornia | $6,857.04 | $461.45 |
| Marin County, CACalifornia | $8,040.94 | $500.99 |
| San Francisco, CACalifornia | $8,039.16 | $499.21 |
| San Benito County, CACalifornia | $8,224.15 | $513.08 |
| Santa Clara County, CACalifornia | $8,216.86 | $505.79 |
| San Luis Obispo, CACalifornia | $6,541.44 | $450.66 |
| Santa Cruz, CACalifornia | $6,958.07 | $460.87 |
| Santa Maria, CACalifornia | $6,692.15 | $456.99 |
| Santa Rosa, CACalifornia | $7,031.67 | $464.96 |
| Stockton, CACalifornia | $6,306.36 | $445.52 |
| Vallejo, CACalifornia | $7,528.96 | $480.98 |
| Visalia, CACalifornia | $6,306.36 | $445.52 |
| Yuba City, CACalifornia | $6,306.36 | $445.52 |
| ColoradoColorado | $6,142.85 | $453.13 |
| ConnecticutConnecticut | $6,238.68 | $479.44 |
| DelawareDelaware | $5,731.58 | $448.26 |
| Fort Lauderdale, FLFlorida | $5,914.51 | $497.51 |
| Rest of FloridaFlorida | $5,586.89 | $474.70 |
| Atlanta, GAGeorgia | $5,899.93 | $466.88 |
| Rest of GeorgiaGeorgia | $5,220.69 | $450.74 |
| Hawaii, Guam, HIHawaii | $6,527.98 | $447.89 |
| IowaIowa | $5,304.75 | $411.80 |
| IdahoIdaho | $5,336.07 | $416.38 |
| East St. Louis, ILIllinois | $5,416.88 | $497.19 |
| Rest of IllinoisIllinois | $5,354.96 | $472.70 |
| Suburban Chicago, ILIllinois | $5,991.13 | $499.27 |
| IndianaIndiana | $5,375.02 | $417.90 |
| KansasKansas | $5,250.22 | $416.10 |
| KentuckyKentucky | $5,189.77 | $435.85 |
| New Orleans, LALouisiana | $5,485.64 | $453.66 |
| Rest of LouisianaLouisiana | $5,170.15 | $437.63 |
| Metropolitan Boston, MAMassachusetts | $6,867.45 | $482.56 |
| Rest of MassachusettsMassachusetts | $6,084.68 | $453.78 |
| Baltimore area, MDMaryland | $6,217.10 | $479.25 |
| Rest of MarylandMaryland | $5,865.19 | $453.53 |
| Rest of MaineMaine | $5,343.88 | $424.20 |
| Southern Maine, MEMaine | $5,732.51 | $433.16 |
| Detroit, MIMichigan | $5,645.69 | $485.37 |
| Rest of MichiganMichigan | $5,332.20 | $449.95 |
| MinnesotaMinnesota | $5,922.70 | $420.13 |
| Metropolitan Kansas City, MOMissouri | $5,466.37 | $445.08 |
| Metropolitan St. Louis, MOMissouri | $5,538.75 | $447.95 |
| Rest of MissouriMissouri | $5,045.25 | $435.72 |
| MississippiMississippi | $5,027.46 | $423.28 |
| MontanaMontana | $5,800.96 | $453.48 |
| North CarolinaNorth Carolina | $5,415.84 | $426.64 |
| NebraskaNebraska | $5,347.49 | $411.76 |
| New HampshireNew Hampshire | $6,018.66 | $451.93 |
| Northern New JerseyNew Jersey | $6,697.10 | $494.02 |
| Rest of New JerseyNew Jersey | $6,320.39 | $480.93 |
| New MexicoNew Mexico | $5,357.84 | $454.20 |
| NevadaNevada | $5,797.78 | $444.95 |
| NYC suburbs and Long Island, NYNew York | $6,897.30 | $539.14 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $6,344.12 | $488.63 |
| Queens, NYNew York | $6,837.27 | $516.55 |
| Rest of New YorkNew York | $5,512.14 | $432.03 |
| OhioOhio | $5,325.85 | $443.60 |
| OklahomaOklahoma | $5,204.40 | $429.10 |
| Portland, OROregon | $6,398.99 | $457.94 |
| Rest of OregonOregon | $5,763.63 | $437.53 |
| Metropolitan Philadelphia, PAPennsylvania | $6,040.41 | $473.68 |
| Rest of PennsylvaniaPennsylvania | $5,349.89 | $440.89 |
| Puerto RicoPuerto Rico | $5,860.42 | $454.11 |
| Rhode IslandRhode Island | $5,981.17 | $457.22 |
| South CarolinaSouth Carolina | $5,377.71 | $436.63 |
| South DakotaSouth Dakota | $5,766.25 | $418.76 |
| TennesseeTennessee | $5,279.29 | $418.42 |
| Austin, TXTexas | $6,112.74 | $455.10 |
| Beaumont, TXTexas | $5,305.31 | $439.10 |
| Brazoria, TXTexas | $5,742.58 | $443.22 |
| Dallas, TXTexas | $5,774.29 | $448.19 |
| Fort Worth, TXTexas | $5,720.30 | $447.68 |
| Galveston, TXTexas | $5,756.03 | $445.98 |
| Houston, TXTexas | $5,784.77 | $474.72 |
| Rest of TexasTexas | $5,517.16 | $442.40 |
| UtahUtah | $5,467.70 | $441.06 |
| VirginiaVirginia | $5,692.71 | $436.13 |
| Virgin Islands, VIUnited States Virgin Islands | $5,860.42 | $454.11 |
| VermontVermont | $5,720.49 | $426.48 |
| Rest of WashingtonWashington | $6,081.95 | $451.05 |
| King County, WAWashington | $7,046.57 | $485.21 |
| WisconsinWisconsin | $5,535.16 | $412.27 |
| West VirginiaWest Virginia | $5,107.48 | $460.52 |
| WyomingWyoming | $5,787.43 | $439.95 |
22513 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $6,273.67 | 1 |
| AL | $5,094.93 | 1 |
| AR | $5,004.78 | 1 |
| AZ | $5,624.04 | 1 |
| CA | $6,306.36–$8,224.15 | 29 |
| CO | $6,142.85 | 1 |
| CT | $6,238.68 | 1 |
| DC | $6,795.34 | 1 |
| DE | $5,731.58 | 1 |
| FL | $5,586.89–$6,105.40 | 3 |
| GA | $5,220.69–$5,899.93 | 2 |
| GU | $6,527.98 | 1 |
| HI | $6,527.98 | 1 |
| IA | $5,304.75 | 1 |
| ID | $5,336.07 | 1 |
| IL | $5,354.96–$5,991.13 | 4 |
| IN | $5,375.02 | 1 |
| KS | $5,250.22 | 1 |
| KY | $5,189.77 | 1 |
| LA | $5,170.15–$5,485.64 | 2 |
| MA | $6,084.68–$6,867.45 | 2 |
| MD | $5,865.19–$6,795.34 | 3 |
| ME | $5,343.88–$5,732.51 | 2 |
| MI | $5,332.20–$5,645.69 | 2 |
| MN | $5,922.70 | 1 |
| MO | $5,045.25–$5,538.75 | 3 |
| MS | $5,027.46 | 1 |
| MT | $5,800.96 | 1 |
| NC | $5,415.84 | 1 |
| ND | $5,769.92 | 1 |
| NE | $5,347.49 | 1 |
| NH | $6,018.66 | 1 |
| NJ | $6,320.39–$6,697.10 | 2 |
| NM | $5,357.84 | 1 |
| NV | $5,797.78 | 1 |
| NY | $5,512.14–$6,897.30 | 5 |
| OH | $5,325.85 | 1 |
| OK | $5,204.40 | 1 |
| OR | $5,763.63–$6,398.99 | 2 |
| PA | $5,349.89–$6,040.41 | 2 |
| PR | $5,860.42 | 1 |
| RI | $5,981.17 | 1 |
| SC | $5,377.71 | 1 |
| SD | $5,766.25 | 1 |
| TN | $5,279.29 | 1 |
| TX | $5,305.31–$6,112.74 | 8 |
| UT | $5,467.70 | 1 |
| VA | $5,692.71–$6,795.34 | 2 |
| VI | $5,860.42 | 1 |
| VT | $5,720.49 | 1 |
| WA | $6,081.95–$7,046.57 | 2 |
| WI | $5,535.16 | 1 |
| WV | $5,107.48 | 1 |
| WY | $5,787.43 | 1 |
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.
The exact North Dakota 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
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.43 | × 1.000 | 8.4300 |
| Practice expense | 163.68 | × 1.000 | 163.6800 |
| Malpractice | 1.57 | × 0.406 | 0.6374 |
| Total RVUs | 172.7474 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$5769.92
Office: (8.43 × 1 + 163.68 × 1 + 1.57 × 0.406) × $33.4009 = $5769.92
Facility: (8.43 × 1 + 3.58 × 1 + 1.57 × 0.406) × $33.4009 = $422.44
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%).
How 22513 has changed in North Dakota
22513 · Office / nonfacility
$5769.92
Effective 2026-10-01
The base rate is $588.11 higher than on 2025-10-01, moving from $5181.81 to $5769.92 (11.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$5181.81changed to$5769.92
- 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
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$5576.08changed to$5181.81
- 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.
March 9, 2024
RVU24AR
$5485.07changed to$5576.08
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$5860.74changed to$5485.07
- 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
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$6183.02changed to$5860.74
- 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
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$6784.94changed to$6183.02
- 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.
January 1, 2021
RVU21A
$6798.84changed to$6784.94
- 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
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$7021.09changed to$6798.84
- 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
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$7301.42changed to$7021.09
- 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.
January 1, 2018
RVU18AR1
$7283.15changed to$7301.42
- 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
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$7443.46changed to$7283.15
- 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
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$7467.40changed to$7443.46
- 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.
July 1, 2015
RVU15C
$7430.24changed to$7467.40
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$7430.24
Held through RVU15B.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $5,769.92 | $422.44 | RVU26D |
| 2026-07-01 | $5,769.92 | $422.44 | RVU26C |
| 2026-04-01 | $5,769.92 | $422.44 | RVU26B |
| 2026-01-01 | $5,769.92 | $422.44 | RVU26A |
| 2025-10-01 | $5,181.81 | $468.60 | RVU25D |
| 2025-07-01 | $5,181.81 | $468.60 | RVU25C |
| 2025-04-01 | $5,181.81 | $468.60 | RVU25B |
| 2025-01-01 | $5,181.81 | $468.60 | RVU25A |
| 2024-10-01 | $5,576.08 | $480.10 | RVU24D |
| 2024-07-01 | $5,576.08 | $480.10 | RVU24C |
| 2024-04-01 | $5,576.08 | $480.10 | RVU24B |
| 2024-03-09 | $5,576.08 | $480.10 | RVU24AR |
| 2024-01-01 | $5,485.07 | $472.26 | RVU24A |
| 2023-10-01 | $5,860.74 | $484.87 | RVU23D |
| 2023-07-01 | $5,860.74 | $484.87 | RVU23C |
| 2023-04-01 | $5,860.74 | $484.87 | RVU23B |
| 2023-01-01 | $5,860.74 | $484.87 | RVU23A |
| 2022-10-01 | $6,183.02 | $488.92 | RVU22D |
| 2022-07-01 | $6,183.02 | $488.92 | RVU22C |
| 2022-04-01 | $6,183.02 | $488.92 | RVU22B |
| 2022-01-01 | $6,183.02 | $488.92 | RVU22A |
| 2021-10-01 | $6,784.94 | $492.67 | RVU21D |
| 2021-07-01 | $6,784.94 | $492.67 | RVU21C |
| 2021-04-01 | $6,784.94 | $492.67 | RVU21B |
| 2021-01-01 | $6,784.94 | $492.67 | RVU21A |
| 2020-10-01 | $6,798.84 | $507.70 | RVU20D |
| 2020-07-01 | $6,798.84 | $507.70 | RVU20C |
| 2020-04-01 | $6,798.84 | $507.70 | RVU20B |
| 2020-01-01 | $6,798.84 | $507.70 | RVU20A |
| 2019-10-01 | $7,021.09 | $512.79 | RVU19D |
| 2019-07-01 | $7,021.09 | $512.79 | RVU19C |
| 2019-04-01 | $7,021.09 | $512.79 | RVU19B |
| 2019-01-01 | $7,021.09 | $512.79 | RVU19A |
| 2018-10-01 | $7,301.42 | $514.77 | RVU18D |
| 2018-07-01 | $7,301.42 | $514.77 | RVU18C |
| 2018-04-01 | $7,301.42 | $514.77 | RVU18B |
| 2018-01-01 | $7,301.42 | $514.77 | RVU18AR1 |
| 2017-10-01 | $7,283.15 | $515.62 | RVU17D |
| 2017-07-01 | $7,283.15 | $515.62 | RVU17C |
| 2017-04-01 | $7,283.15 | $515.62 | RVU17B |
| 2017-01-01 | $7,283.15 | $515.62 | RVU17A |
| 2016-10-01 | $7,443.46 | $531.44 | RVU16D |
| 2016-07-01 | $7,443.46 | $531.44 | RVU16C |
| 2016-04-01 | $7,443.46 | $531.44 | RVU16B |
| 2016-01-01 | $7,443.46 | $531.44 | RVU16A |
| 2015-10-01 | $7,467.40 | $534.39 | RVU15D |
| 2015-07-01 | $7,467.40 | $534.39 | RVU15C |
| 2015-04-01 | $7,430.24 | $531.73 | RVU15B |
| 2015-01-01 | $7,430.24 | $531.73 | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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.
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