CPT code 98925: Osteopathic manipulation, one or two regions2026 Medicare rate & RVUs in Massachusetts
Osteopathic manipulative treatment for somatic dysfunction in one or two body regions, selected by the regions treated rather than the number of techniques used.
Medicare pays $33.30–$36.08 for 98925 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 98925 covers
98925 represents osteopathic manipulative treatment directed to somatic dysfunction in one or two of the seven body regions: head, cervical, thoracic, lumbar, sacral, pelvic, or extremity. An osteopathic physician typically performs hands-on techniques such as muscle energy or myofascial release in an office or outpatient setting. Select the code based on the distinct regions treated, not the number of techniques or findings within a region. Document the treated regions and clinical findings supporting the manipulation.
CMS assigns a minor-procedure 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for bilateral adjustment. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeon and team-surgery billing are not permitted. A separately identifiable E/M service may be reported when its work is distinct from the manipulation and is documented accordingly.
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.
Where 98925 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $36.08 | $20.93 |
| Rest of Massachusetts | $33.30 | $19.94 |
How the 98925 rate is calculated
Each of 98925’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 98925
RVUs × geographic indexes × conversion factor
Work0.45
0.45 RVUs× 1.000 GPCI
Practice expense0.49
0.49 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
0.9700
Conversion factor
$33.4009
Medicare rate
$32.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 98925
The CMS indicators that decide how 98925 is paid alongside other services.
CMS payment indicators · 98925
Osteopathic manipulation, one or two regions
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
98925 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 98926Osteopathic manipulationThree to four regions
- Use 98925 when one or two body regions are treated. Use 98926 when three or four are treated.
- 98927Osteopathic manipulationFive to six regions
- 98927 covers osteopathic manipulation of five or six body regions; 98925 covers one or two.
- 98940Chiropractic adjustmentSpinal, 1–2 regions
- 98940 describes chiropractic manipulative treatment for one or two spinal regions. Choose according to the service performed, not simply the body-region count.
98925 billing questions
How is 98925 distinguished from 98926?
Count the distinct body regions treated. Report 98925 for one or two regions; 98926 is for three or four.
Does the number of techniques or findings change the region count?
No. Select the code by the number of distinct body regions treated, not by the number of techniques or individual findings in a region.
Can an E/M service be reported on the same date?
A separately identifiable E/M service may be reported when it involves distinct work beyond the manipulation. Document that work and use modifier 25 when appropriate.
Should modifier 50 be used when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the treated regions without modifier 50.
What documentation supports 98925?
Document the somatic dysfunction findings, the one or two regions treated, and the manipulation performed.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the service under the 0-day global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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