Use 22100 for the cervical region; 22101 describes the corresponding partial excision at a thoracic vertebral segment.
On this page
CMS RVU26D · Effective 2026-10-01
22101 Vertebral excision Medicare reimbursement rates in Colorado
Reports partial removal of a thoracic vertebral segment to treat an intrinsic bone lesion, such as vertebral osteomyelitis. Compare 22101 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 22101 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$872.11
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Spine surgery
About 22101: Partial thoracic vertebral lesion excision
Reports partial removal of a thoracic vertebral segment to treat an intrinsic bone lesion, such as vertebral osteomyelitis.
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.
CMS billing rules for 22101
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.80 · 42%
- Practice expense (office) RVU11.75 · 45%
- Malpractice RVU3.43 · 13%
107
Medicare services in 2024 · #4826 by national volume
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.
22101 compared with similar codes
Office rates for Colorado, from the same CMS release.
Use 22102 for the lumbar region. The lesion and partial-removal concept are similar, but the vertebral region differs.
22103 reports each additional vertebral segment as an add-on; it does not replace 22101 for the first thoracic segment.
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.
Compare 22101 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$872.11
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 22101 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,044
- Code
- 22101
- Physician work
- 10.80
- Practice expense
- 11.75
- Malpractice
- 3.43
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.80 | × 1.012 | 10.9296 |
| Practice expense | 11.75 | × 1.064 | 12.5020 |
| Malpractice | 3.43 | × 0.781 | 2.6788 |
| Total RVUs | 26.1104 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$872.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.8 | 1.012 |
| Practice expense | 11.75 | 1.064 |
| Malpractice | 3.43 | 0.781 |
(10.8 × 1.012 + 11.75 × 1.064 + 3.43 × 0.781) × $33.4009 = $872.11
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
22101 billing questions
How is 22101 different from 22112?
22101 describes partial removal of thoracic vertebral bone for an intrinsic lesion. 22112 is for excision of a benign tumor or cyst of a thoracic vertebral body.
Can 22103 be reported with 22101?
22103 represents each additional vertebral segment and is an add-on to 22101 when the work extends to another segment. Document the additional segment treated.
What documentation supports 22101?
The operative report should identify the thoracic level, the intrinsic bone lesion, and the portion of vertebra removed. It should support treatment of a single segment for this code.
Is modifier 50 appropriate for this service?
No. CMS identifies bilateral adjustment as inappropriate for this code; the thoracic vertebral procedure is not reported as a bilateral service.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90 days after surgery are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
