$6,089.00–$7,057.87
Choose 22513 for the initial thoracic vertebral body and 22514 for the initial lumbar body; the treated region determines the code.
On this page
CMS RVU26D · Effective 2026-10-01
22513 Vertebral augmentation Medicare reimbursement rates in Washington
Percutaneous thoracic vertebral augmentation stabilizes a painful compression fracture through cavity creation and cement placement, reported for the first treated vertebral body. Compare 22513 office and facility rates across CMS payment localities in Washington.
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 22513 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$6081.95–$7046.57
2 of 2 localities have a supported rate.
Facility setting
$451.05–$485.21
2 of 2 localities have a supported rate.
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 procedure
About 22513: Percutaneous thoracic vertebral augmentation
Percutaneous thoracic vertebral augmentation stabilizes a painful compression fracture through cavity creation and cement placement, reported for the first treated vertebral body.
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.
CMS billing rules for 22513
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.43 · 5%
- Practice expense (office) RVU163.68 · 94%
- Malpractice RVU1.57 · 1%
19.1K
Medicare services in 2024 · #1164 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.
22513 compared with similar codes
Office rates for Washington, from the same CMS release.
$3,122.59–$3,619.75
22515 is an add-on for an additional treated vertebral body, not the initial body reported with 22513.
$1,835.08–$2,102.08
22510 describes vertebroplasty by cement injection in the cervicothoracic region. 22513 is thoracic augmentation involving cavity creation.
Compare 22513 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.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
$6081.95
Facility
$451.05
Seattle (King Cnty) →
Office / nonfacility
$7046.57
Facility
$485.21
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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 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.
2,07122510,,Perq cervicothoracic inject,A,,7.70,43.93,,2.61,,1.16,52.79,11.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07222511,,Perq lumbosacral injection,A,,7.15,44.89,,2.60,,1.07,53.11,10.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07322512,,Vertebroplasty addl inject,A,,3.90,17.53,,0.81,,0.72,22.15,5.43,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07422513,,Perq vertebral augmentation,A,,8.43,163.68,,3.58,,1.57,173.68,13.58,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07522514,,Perq vertebral augmentation,A,,7.79,164.59,,3.47,,1.44,173.82,12.70,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07622515,,Perq vertebral augmentation,A,,3.90,84.46,,0.97,,0.79,89.15,5.66,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07722526,,Idet single level,N,+,5.70,51.76,,2.36,,0.60,58.06,8.66,9,010,0.10,0.80,0.10,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00