Billing code 22101: Vertebral excisionMedicare rate & RVUs

Medicare pays $867.76 for 22101 nationally in a facility.

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

What 22101 covers

A spine surgeon reports this service when removing part of a thoracic vertebra to address a lesion arising in the bone, such as osteomyelitis. The procedure is performed in a surgical setting; Medicare recorded facility services for this code in 2024. The code distinguishes a partial removal at the thoracic level from procedures for cervical or lumbar vertebrae and from codes describing excision of a benign vertebral tumor.

Choose the code based on the operative report’s documented spinal level, lesion, and extent of bone removal. Documentation should identify the treated vertebral segment and support that only part of it was removed for the intrinsic lesion. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery 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 22101 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

22101 rates by state

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

How the 22101 rate is calculated

Each of 22101’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 22101

22101 has a 90-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

22101 compared with similar codes

How to choose

22100Vertebral lesion excision

Use 22100 for the cervical region; 22101 describes the corresponding partial excision at a thoracic vertebral segment.

22102Vertebral excision

Use 22102 for the lumbar region. The lesion and partial-removal concept are similar, but the vertebral region differs.

22103Spine lesion excision

22103 reports each additional vertebral segment as an add-on; it does not replace 22101 for the first thoracic segment.

22112Vertebral excision

22112 describes excision of a benign tumor or cyst of a thoracic vertebral body; 22101 is for partial removal to treat an intrinsic bone lesion.

Codes related to 22101

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

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