CPT code 98941: Chiropractic adjustment, spinal, 3-4 regions2026 Medicare rate & RVUs in Iowa
Report chiropractic manipulation of three or four spinal regions when a chiropractor treats documented subluxations in those regions during one visit.
In Iowa, Medicare pays $36.93 for 98941 in the office and $27.46 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 98941 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 98941 covers
A chiropractor manipulates three or four of the five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. Treatment usually occurs in an office and may use hands-on, instrument-assisted, or drop-table techniques. A visit treating documented subluxations in the cervical, thoracic, and lumbar regions is an example. Count regions treated, not individual vertebrae adjusted or sides of the spine.
Document the subluxation, supporting findings, and manipulation for each counted region. Medicare covers a chiropractor’s manual spinal manipulation to correct subluxation when the subluxation is established by X-ray or physical examination. A physical examination must document at least two PART findings, including asymmetry or restricted range of motion. Use modifier AT for active or corrective treatment; Medicare treats claims without AT as maintenance care and denies them. The 0-day global period includes routine same-day preoperative and postoperative care. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; 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.
How Iowa compares for 98941
Across 109 of 109 payment localities, the office rate for 98941 runs from $36.13 in Arkansas to $50.76 in Alaska. Iowa pays $36.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$36.93
- Los Angeles, CA · California$41.99+$5.06
- Washington, DC area · District of Columbia$42.37+$5.44
- Miami, FL · Florida$39.54+$2.61
- Chicago, IL · Illinois$39.08+$2.15
- Manhattan, NY · New York$42.52+$5.59
- Alaska · Alaska$50.76+$13.83
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $36.39 | $27.33 |
| ArkansasArkansas | $36.13 | $27.24 |
| ArizonaArizona | $37.90 | $27.86 |
| Bakersfield, CACalifornia | $40.16 | $28.81 |
| Chico, CACalifornia | $40.09 | $28.74 |
| El Centro, CACalifornia | $40.09 | $28.74 |
| Fresno, CACalifornia | $40.09 | $28.74 |
| Hanford, CACalifornia | $40.09 | $28.74 |
| Madera, CACalifornia | $40.09 | $28.74 |
| Merced, CACalifornia | $40.09 | $28.74 |
| Modesto, CACalifornia | $40.09 | $28.74 |
| Napa, CACalifornia | $44.48 | $30.83 |
| Oxnard, CACalifornia | $41.67 | $29.43 |
| Redding, CACalifornia | $40.09 | $28.74 |
| Rest of CaliforniaCalifornia | $40.09 | $28.74 |
| Riverside, CACalifornia | $40.22 | $28.87 |
| Sacramento, CACalifornia | $41.54 | $29.49 |
| Salinas, CACalifornia | $41.36 | $29.36 |
| San Diego, CACalifornia | $41.90 | $29.51 |
| Marin County, CACalifornia | $46.58 | $31.98 |
| San Francisco, CACalifornia | $46.57 | $31.97 |
| San Benito County, CACalifornia | $47.43 | $32.50 |
| Santa Clara County, CACalifornia | $47.39 | $32.46 |
| San Luis Obispo, CACalifornia | $40.74 | $28.94 |
| Santa Cruz, CACalifornia | $41.97 | $29.39 |
| Santa Maria, CACalifornia | $41.40 | $29.32 |
| Santa Rosa, CACalifornia | $42.37 | $29.66 |
| Stockton, CACalifornia | $40.09 | $28.74 |
| Vallejo, CACalifornia | $44.46 | $30.82 |
| Visalia, CACalifornia | $40.09 | $28.74 |
| Yuba City, CACalifornia | $40.09 | $28.74 |
| ColoradoColorado | $39.58 | $28.56 |
| ConnecticutConnecticut | $40.10 | $28.95 |
| DelawareDelaware | $38.31 | $28.08 |
| Fort Lauderdale, FLFlorida | $38.88 | $28.39 |
| Rest of FloridaFlorida | $37.92 | $28.02 |
| Atlanta, GAGeorgia | $38.79 | $28.27 |
| Rest of GeorgiaGeorgia | $36.85 | $27.62 |
| Hawaii, Guam, HIHawaii | $40.33 | $28.56 |
| IdahoIdaho | $37.03 | $27.51 |
| East St. Louis, ILIllinois | $37.55 | $28.02 |
| Rest of IllinoisIllinois | $37.29 | $27.84 |
| Suburban Chicago, ILIllinois | $39.24 | $28.60 |
| IndianaIndiana | $37.14 | $27.54 |
| KansasKansas | $36.80 | $27.44 |
| KentuckyKentucky | $36.71 | $27.51 |
| New Orleans, LALouisiana | $37.57 | $27.83 |
| Rest of LouisianaLouisiana | $36.67 | $27.50 |
| Metropolitan Boston, MAMassachusetts | $42.24 | $29.87 |
| Rest of MassachusettsMassachusetts | $39.51 | $28.61 |
| Baltimore area, MDMaryland | $39.96 | $28.85 |
| Rest of MarylandMaryland | $38.79 | $28.32 |
| Rest of MaineMaine | $37.08 | $27.56 |
| Southern Maine, MEMaine | $38.15 | $27.89 |
| Detroit, MIMichigan | $38.11 | $28.12 |
| Rest of MichiganMichigan | $37.15 | $27.69 |
| MinnesotaMinnesota | $38.61 | $27.96 |
| Metropolitan Kansas City, MOMissouri | $37.49 | $27.76 |
| Metropolitan St. Louis, MOMissouri | $37.69 | $27.83 |
| Rest of MissouriMissouri | $36.33 | $27.40 |
| MississippiMississippi | $36.23 | $27.32 |
| MontanaMontana | $38.41 | $28.06 |
| North CarolinaNorth Carolina | $37.28 | $27.62 |
| North DakotaNorth Dakota | $38.21 | $27.86 |
| NebraskaNebraska | $37.05 | $27.49 |
| New HampshireNew Hampshire | $38.99 | $28.21 |
| Northern New JerseyNew Jersey | $42.29 | $30.28 |
| Rest of New JerseyNew Jersey | $40.75 | $29.44 |
| New MexicoNew Mexico | $37.23 | $27.74 |
| NevadaNevada | $38.37 | $28.01 |
| NYC suburbs and Long Island, NYNew York | $43.01 | $30.70 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $40.95 | $29.61 |
| Queens, NYNew York | $42.77 | $30.53 |
| Rest of New YorkNew York | $37.56 | $27.72 |
| OhioOhio | $37.11 | $27.65 |
| OklahomaOklahoma | $36.73 | $27.48 |
| Portland, OROregon | $40.36 | $28.86 |
| Rest of OregonOregon | $38.25 | $27.94 |
| Metropolitan Philadelphia, PAPennsylvania | $39.51 | $28.73 |
| Rest of PennsylvaniaPennsylvania | $37.16 | $27.65 |
| Puerto RicoPuerto Rico | $38.57 | $28.10 |
| Rhode IslandRhode Island | $39.31 | $28.61 |
| South CarolinaSouth Carolina | $37.22 | $27.65 |
| South DakotaSouth Dakota | $38.19 | $27.83 |
| TennesseeTennessee | $36.89 | $27.48 |
| Austin, TXTexas | $39.29 | $28.34 |
| Beaumont, TXTexas | $37.03 | $27.61 |
| Brazoria, TXTexas | $38.39 | $28.13 |
| Dallas, TXTexas | $38.51 | $28.20 |
| Fort Worth, TXTexas | $38.36 | $28.16 |
| Galveston, TXTexas | $38.43 | $28.15 |
| Houston, TXTexas | $38.62 | $28.33 |
| Rest of TexasTexas | $37.61 | $27.79 |
| UtahUtah | $37.48 | $27.74 |
| VirginiaVirginia | $38.06 | $27.88 |
| Virgin Islands, VIUnited States Virgin Islands | $38.57 | $28.10 |
| VermontVermont | $38.10 | $27.84 |
| Rest of WashingtonWashington | $39.43 | $28.52 |
| King County, WAWashington | $42.91 | $30.21 |
| WisconsinWisconsin | $37.55 | $27.63 |
| West VirginiaWest Virginia | $36.59 | $27.59 |
| WyomingWyoming | $38.32 | $27.97 |
98941 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$36.13
$50.76
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $50.76 | 1 |
| AL | $36.39 | 1 |
| AR | $36.13 | 1 |
| AZ | $37.90 | 1 |
| CA | $40.09–$47.43 | 29 |
| CO | $39.58 | 1 |
| CT | $40.10 | 1 |
| DC | $42.37 | 1 |
| DE | $38.31 | 1 |
| FL | $37.92–$39.54 | 3 |
| GA | $36.85–$38.79 | 2 |
| GU | $40.33 | 1 |
| HI | $40.33 | 1 |
| IA | $36.93 | 1 |
| ID | $37.03 | 1 |
| IL | $37.29–$39.24 | 4 |
| IN | $37.14 | 1 |
| KS | $36.80 | 1 |
| KY | $36.71 | 1 |
| LA | $36.67–$37.57 | 2 |
| MA | $39.51–$42.24 | 2 |
| MD | $38.79–$42.37 | 3 |
| ME | $37.08–$38.15 | 2 |
| MI | $37.15–$38.11 | 2 |
| MN | $38.61 | 1 |
| MO | $36.33–$37.69 | 3 |
| MS | $36.23 | 1 |
| MT | $38.41 | 1 |
| NC | $37.28 | 1 |
| ND | $38.21 | 1 |
| NE | $37.05 | 1 |
| NH | $38.99 | 1 |
| NJ | $40.75–$42.29 | 2 |
| NM | $37.23 | 1 |
| NV | $38.37 | 1 |
| NY | $37.56–$43.01 | 5 |
| OH | $37.11 | 1 |
| OK | $36.73 | 1 |
| OR | $38.25–$40.36 | 2 |
| PA | $37.16–$39.51 | 2 |
| PR | $38.57 | 1 |
| RI | $39.31 | 1 |
| SC | $37.22 | 1 |
| SD | $38.19 | 1 |
| TN | $36.89 | 1 |
| TX | $37.03–$39.29 | 8 |
| UT | $37.48 | 1 |
| VA | $38.06–$42.37 | 2 |
| VI | $38.57 | 1 |
| VT | $38.10 | 1 |
| WA | $39.43–$42.91 | 2 |
| WI | $37.55 | 1 |
| WV | $36.59 | 1 |
| WY | $38.32 | 1 |
How the 98941 rate is calculated
Each of 98941’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 · 98941
RVUs × geographic indexes × conversion factor
Work0.69
0.69 RVUs× 1.000 GPCI
Practice expense0.45
0.45 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.1500
Conversion factor
$33.4009
Medicare rate
$38.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,943
- Code
- 98941
- Physician work
- 0.69
- Practice expense
- 0.45
- Malpractice
- 0.01
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.69 | × 1.000 | 0.6900 |
| Practice expense | 0.45 | × 0.915 | 0.4118 |
| Malpractice | 0.01 | × 0.397 | 0.0040 |
| Total RVUs | 1.1057 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$36.93
Office: (0.69 × 1 + 0.45 × 0.915 + 0.01 × 0.397) × $33.4009 = $36.93
Facility: (0.69 × 1 + 0.14 × 0.915 + 0.01 × 0.397) × $33.4009 = $27.46
Payment rules and modifiers for 98941
The CMS indicators that decide how 98941 is paid alongside other services.
CMS payment indicators · 98941
Chiropractic adjustment, spinal, 3-4 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. |
How 98941 has changed in Iowa
98941 · Office / nonfacility
$36.93
Effective 2026-10-01
The base rate is $0.06 lower than on 2025-10-01, moving from $36.99 to $36.93 (0.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$36.99changed to$36.93
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.71 changed to 0.69
- Practice expense RVU 0.47 changed to 0.45
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$37.77changed to$36.99
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.46 changed to 0.47
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$37.15changed to$37.77
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$38.39changed to$37.15
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$38.53changed to$38.39
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.44 changed to 0.46
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$38.85changed to$38.53
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$39.85changed to$38.85
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.43 changed to 0.44
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$39.95changed to$39.85
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.02 changed to 0.01
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$39.90changed to$39.95
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$39.41changed to$39.90
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.42 changed to 0.43
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$39.25changed to$39.41
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$39.39changed to$39.25
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$39.19changed to$39.39
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$39.37changed to$39.19
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.03 changed to 0.02
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
July 1, 2014
RVU14C
No ratechanged to$39.37
Held through RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $36.93 | $27.46 | RVU26D |
| 2026-07-01 | $36.93 | $27.46 | RVU26C |
| 2026-04-01 | $36.93 | $27.46 | RVU26B |
| 2026-01-01 | $36.93 | $27.46 | RVU26A |
| 2025-10-01 | $36.99 | $31.68 | RVU25D |
| 2025-07-01 | $36.99 | $31.68 | RVU25C |
| 2025-04-01 | $36.99 | $31.68 | RVU25B |
| 2025-01-01 | $36.99 | $31.68 | RVU25A |
| 2024-10-01 | $37.77 | $32.30 | RVU24D |
| 2024-07-01 | $37.77 | $32.30 | RVU24C |
| 2024-04-01 | $37.77 | $32.30 | RVU24B |
| 2024-03-09 | $37.77 | $32.30 | RVU24AR |
| 2024-01-01 | $37.15 | $31.77 | RVU24A |
| 2023-10-01 | $38.39 | $32.84 | RVU23D |
| 2023-07-01 | $38.39 | $32.84 | RVU23C |
| 2023-04-01 | $38.39 | $32.84 | RVU23B |
| 2023-01-01 | $38.39 | $32.84 | RVU23A |
| 2022-10-01 | $38.53 | $33.19 | RVU22D |
| 2022-07-01 | $38.53 | $33.19 | RVU22C |
| 2022-04-01 | $38.53 | $33.19 | RVU22B |
| 2022-01-01 | $38.53 | $33.19 | RVU22A |
| 2021-10-01 | $38.85 | $33.15 | RVU21D |
| 2021-07-01 | $38.85 | $33.15 | RVU21C |
| 2021-04-01 | $38.85 | $33.15 | RVU21B |
| 2021-01-01 | $38.85 | $33.15 | RVU21A |
| 2020-10-01 | $39.85 | $34.29 | RVU20D |
| 2020-07-01 | $39.85 | $34.29 | RVU20C |
| 2020-04-01 | $39.85 | $34.29 | RVU20B |
| 2020-01-01 | $39.85 | $34.29 | RVU20A |
| 2019-10-01 | $39.95 | $34.06 | RVU19D |
| 2019-07-01 | $39.95 | $34.06 | RVU19C |
| 2019-04-01 | $39.95 | $34.06 | RVU19B |
| 2019-01-01 | $39.95 | $34.06 | RVU19A |
| 2018-10-01 | $39.90 | $34.03 | RVU18D |
| 2018-07-01 | $39.90 | $34.03 | RVU18C |
| 2018-04-01 | $39.90 | $34.03 | RVU18B |
| 2018-01-01 | $39.90 | $34.03 | RVU18AR1 |
| 2017-10-01 | $39.41 | $33.90 | RVU17D |
| 2017-07-01 | $39.41 | $33.90 | RVU17C |
| 2017-04-01 | $39.41 | $33.90 | RVU17B |
| 2017-01-01 | $39.41 | $33.90 | RVU17A |
| 2016-10-01 | $39.25 | $33.79 | RVU16D |
| 2016-07-01 | $39.25 | $33.79 | RVU16C |
| 2016-04-01 | $39.25 | $33.79 | RVU16B |
| 2016-01-01 | $39.25 | $33.79 | RVU16A |
| 2015-10-01 | $39.39 | $33.92 | RVU15D |
| 2015-07-01 | $39.39 | $33.92 | RVU15C |
| 2015-04-01 | $39.19 | $33.75 | RVU15B |
| 2015-01-01 | $39.19 | $33.75 | RVU15A |
| 2014-10-01 | $39.37 | $33.93 | RVU14D |
| 2014-07-01 | $39.37 | $33.93 | RVU14C |
| 2014-04-01 | Additional calculation required | Additional calculation required | RVU14B |
| 2014-01-01 | Additional calculation required | Additional calculation required | RVU14A |
| 2013-10-01 | Additional calculation required | Additional calculation required | RVU13D |
| 2013-07-01 | Additional calculation required | Additional calculation required | RVU13C |
| 2013-04-01 | Additional calculation required | Additional calculation required | RVU13B |
| 2013-01-01 | Additional calculation required | Additional calculation required | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
98941 billing questions
How do I choose between 98940, 98941, and 98942?
Count the distinct spinal regions manipulated and supported by documented subluxations. Use 98940 for one or two regions, 98941 for three or four, and 98942 for all five.
Is the AT modifier required on 98941 for Medicare?
Use AT when the manipulation is active or corrective treatment. Medicare treats a chiropractic manipulation claim without AT as maintenance care and denies it.
Can an E/M visit be billed on the same day as 98941?
Medicare does not cover E/M services furnished by chiropractors, even with modifier 25. For a payer that covers the E/M service, a significant, separately identifiable visit may be reported with modifier 25 on the E/M code; routine assessment around the manipulation is included.
What documentation supports each region counted?
Identify the subluxation and supporting findings for each region, and record the manipulation performed there. For Medicare, a physical examination used to establish subluxation must include at least two PART findings, one of which is asymmetry or restricted motion.
Does Medicare pay for extraspinal manipulation done at the same visit?
Medicare does not cover extraspinal chiropractic manipulation under 98943. Another insurer may cover 98943 alongside 98941 when both spinal and extraspinal regions are treated.
Should modifier 50 be used if both sides of the spine are adjusted?
No. Select 98941 by the number of spinal regions manipulated, not by laterality; modifier 50 is inappropriate.
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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