CPT 22513
Global 010 ActivePerq vertebral augmentation
CPT 22513 Billing & Documentation Guide
CPT code 22513 (Perq vertebral augmentation) is classified under Surgery (Musculoskeletal) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.43, a non-facility practice expense RVU of 163.68, and a malpractice RVU of 1.57, a total non-facility RVU of 173.68 and facility RVU of 13.58. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $6037.81, though rates vary from $5004.78 to $8224.15 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 22513, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 22513 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 22513 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 22513
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.43 | 8.43 |
| Practice Expense RVU | 163.68 | 3.58 |
| Malpractice RVU | 1.57 | 1.57 |
| Total RVU | 173.68 | 13.58 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 22513
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $6789.14 | $461.59 | $6306.36 - $8224.15 | 29 |
| Florida | $5868.93 | $503.63 | $5586.89 - $6105.4 | 3 |
| Georgia | $5560.31 | $458.81 | $5220.69 - $5899.93 | 2 |
| Illinois | $5665.31 | $498.3 | $5354.96 - $5991.13 | 4 |
| Michigan | $5488.95 | $467.66 | $5332.2 - $5645.69 | 2 |
| North Carolina | $5415.84 | $426.64 | $5415.84 - $5415.84 | 1 |
| New York | $6465.26 | $499.61 | $5512.14 - $6897.3 | 5 |
| Ohio | $5325.85 | $443.6 | $5325.85 - $5325.85 | 1 |
| Pennsylvania | $5695.15 | $457.28 | $5349.89 - $6040.41 | 2 |
| Texas | $5714.15 | $449.55 | $5305.31 - $6112.74 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 22513
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 22513 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01935 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01936 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01937 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01938 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01939 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01940 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01941 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01942 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 22513
What does CPT code 22513 mean? +
CPT code 22513 represents: Perq vertebral augmentation. It's in the Surgery (Musculoskeletal) category with a global period of 010.
What is the Medicare reimbursement for CPT 22513? +
The 2026 Medicare national average non-facility payment for CPT 22513 is $6037.81. Rates range from $5004.78 to $8224.15 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 22513? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 22513? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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