CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 22513 RVU and Medicare Payment (2026)
Perq vertebral augmentation — 8.43 work RVU, about $5,801.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.43
- PE RVU (non-facility)
- 163.68
- PE RVU (facility)
- 3.58
- MP RVU
- 1.57
- Office payment
- $5,801.07
- Facility payment
- $453.58
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 22513 in a non-facility setting with national GPCI: (8.43 + 163.68 + 1.57) × $33.4009 ≈ $5,801.07. The same code in a facility setting pays about $453.58 because facility PE RVU (3.58) replaces office PE RVU.
What changes by locality
GPCI moves 22513 non-facility payment from $5,004.78 to $8,224.15 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 22513?
8.43. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 22513 in 2026?
About $5,801.07 non-facility ($453.58 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (8.43) and malpractice RVU stay fixed; only practice expense changes (163.68 office vs 3.58 facility). That is the entire office-vs-facility payment gap.