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

In South Dakota, Medicare pays $5,766.25 for 22513 in the office and $418.76 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.

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 South 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. South Dakota pays $5,766.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

22513 rates by state

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

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.

Payment rules and modifiers for 22513

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

What modifiers do to the payment

When to use modifier 51

Codes related to 22513

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

How 22513 has changed in South Dakota

Price 22513 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates