CPT code 98926: Osteopathic manipulation, three to four regions2026 Medicare rate & RVUs in Massachusetts
Report this service when a physician performs osteopathic manipulative treatment on three or four distinct body regions for documented somatic dysfunction.
Medicare pays $47.34–$51.10 for 98926 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 98926 covers
A physician, commonly an osteopathic physician, uses manual techniques to treat somatic dysfunction in three or four body regions during an office visit or other clinical encounter. The regions may include the head, neck, thoracic or lumbar areas, sacrum, pelvis, ribs, abdomen, or upper or lower extremities. The code reflects the number of distinct regions treated, not the number of techniques used or the number of findings documented.
Document the regions treated and the clinical findings supporting treatment there. Report one service for treatment of three or four regions. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for bilateral treatment. CMS pays an assistant at surgery only when medical necessity is documented; co-surgeons and team surgery are not permitted.
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 98926 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $51.10 | $31.56 |
| Rest of Massachusetts | $47.34 | $30.11 |
How the 98926 rate is calculated
Each of 98926’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 · 98926
RVUs × geographic indexes × conversion factor
Work0.69
0.69 RVUs× 1.000 GPCI
Practice expense0.65
0.65 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.3800
Conversion factor
$33.4009
Medicare rate
$46.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 98926
The CMS indicators that decide how 98926 is paid alongside other services.
CMS payment indicators · 98926
Osteopathic manipulation, three to four 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. |
98926 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 98925Osteopathic manipulationOne or two regions
- Use 98925 when OMT treats one or two distinct regions. Use 98926 when it treats three or four.
- 98927Osteopathic manipulationFive to six regions
- Use 98927 when OMT treats five or six distinct regions; 98926 is for three or four.
- 98941Chiropractic adjustmentSpinal, 3-4 regions
- 98941 describes chiropractic manipulative treatment of three or four spinal regions. 98926 is osteopathic manipulative treatment counted across the broader set of body regions.
98926 billing questions
How do I choose between 98925, 98926, and 98927?
Count the distinct body regions treated: 98925 covers one or two, 98926 covers three or four, and 98927 covers five or six.
Do I count each technique or each side as a separate region?
No. Count distinct treated body regions, not the number of manual techniques or sides treated within a region.
Can an E/M service be reported on the same date?
A significant, separately identifiable E/M service may be reported with modifier 25. The documentation should distinguish that evaluation and management work from the OMT service.
Should modifier 50 be appended when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; treatment on both sides does not make it a bilateral service.
What documentation supports reporting 98926?
Record the somatic dysfunction findings and identify the three or four distinct regions actually treated.
What is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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
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