How much does Medicare pay for CPT 22513?

Medicare allowed an average of $2432.63 per service and paid $1936.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $11,667, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 22513?

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance. It was billed 5,850 times to 5,241 Medicare beneficiaries by 295 providers in 2024.

Does 22513 pay differently in an office than a hospital?

Yes. The allowed amount averaged $5289.06 in an office setting and $570.01 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 22513 most?

Diagnostic Radiology, with 1,612 services from 76 clinicians. Next are Orthopedic Surgery, Neurosurgery, Interventional Radiology.

CPT 22513

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance

$2432.63Medicare-allowed amount per service, averaged across 5,850 services

Providers submitted

$11,667

Asking price, not received

Medicare allowed

$2432.63

The fee schedule figure

Medicare paid

$1936.75

Balance is patient coinsurance

Providers submitted an average of $11,667 for this code and Medicare allowed $2432.63 — 4.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $1936.75 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $5289.06
Hospital / facility: $570.01

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,309 services were billed in an office setting and 3,541 in a facility.

Services: 5,850
Beneficiaries: 5,241
Providers billing it: 295
Total allowed: $14,230,886

What Medicare pays for CPT 22513

Across 5,850 services billed by 295 providers to 5,241 beneficiaries, Medicare allowed an average of $2432.63 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 22513

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,612	1,432	$1546.24	76
Orthopedic Surgery	1,541	1,358	$3072.63	71
Neurosurgery	943	865	$1947.45	51
Interventional Radiology	577	537	$1500.45	32
Interventional Pain Management	375	324	$3645.24	17
Pain Management	323	279	$3899.55	19
Anesthesiology	181	167	$3694.49	11
Physical Medicine and Rehabilitation	148	138	$3518.29	8
Ambulatory Surgical Center	111	104	$3047.52	7
Osteopathic Manipulative Medicine	26	25	$5380.98	2
Neurology	13	12	$544.44	1

22513 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	1,178	$3841.65	$3073.86	50
Texas	421	$1100.67	$888.11	25
Oklahoma	355	$3439.47	$3175.73	13
Virginia	234	$3424.85	$2561.21	11
Ohio	215	$483.13	$392.24	9
North Carolina	213	$1554.76	$1280.56	11
Massachusetts	207	$1470.48	$1101.04	10
California	206	$4239.83	$2844.58	11
New York	206	$1858.64	$1370.46	9
Kansas	198	$1237.85	$1099.71	11
Missouri	196	$478.28	$391.59	11
Illinois	183	$2034.87	$1608.91	12
Mississippi	175	$821.59	$795.49	6
Michigan	158	$1982.47	$1717.66	10
Arkansas	151	$1463.83	$1293.64	8
Indiana	149	$1804.20	$1541.54	10
Washington	145	$2959.18	$2175.83	6
Arizona	144	$5209.59	$4371.21	8
Georgia	132	$1298.81	$1137.05	8
Pennsylvania	131	$1595.95	$1298.02	8
Tennessee	108	$4023.55	$3565.54	5
Maryland	87	$2696.33	$1980.31	4
New Jersey	85	$4159.60	$3157.63	4
South Carolina	77	$1564.94	$1323.99	5
Alabama	70	$3293.13	$3003.53	3
Wisconsin	67	$1180.72	$967.03	4
North Dakota	55	$471.39	$394.38	3
Kentucky	49	$1828.82	$1616.32	3
Nebraska	49	$1245.35	$1035.44	3
Delaware	32	$463.21	$382.43	2
Idaho	31	$456.58	$391.89	2
Utah	26	$5725.51	$4375.35	2
Iowa	22	$443.18	$396.35	1
Minnesota	17	$449.88	$382.68	1
Hawaii	15	$5792.81	$4376.05	1
New Mexico	14	$5055.14	$4381.95	1
Wyoming	13	$483.05	$395.94	1
South Dakota	12	$463.66	$380.72	1
Montana	12	$488.80	$396.40	1
Rhode Island	12	$501.30	$396.40	1

Related codes

22558Fusion of lower spine bone through abdomen$707.92
22551Fusion of upper spine bone$1377.46
22552Fusion of upper spine bone$268.72
22585Fusion of spine bones through front of body$215.15
22514Treatment of broken lower spine bone$2517.60
22515Treatment of broken spine bone$1212.70

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.