CPT code 98942: Chiropractic adjustment, spinal, five regions2026 Medicare rate & RVUs in Iowa
Report chiropractic spinal manipulation at this level when treatment is documented in all five regions: cervical, thoracic, lumbar, sacral, and pelvic.
In Iowa, Medicare pays $48.03 for 98942 in the office and $37.34 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 98942 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 98942 covers
Chiropractic manipulative treatment at this level addresses all five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. A chiropractor performs the spinal adjustment, usually in an office, although it can also occur in a facility. The pelvic region includes the sacroiliac area. The visit qualifies only when manipulation, not merely examination, occurs in each of the five distinct regions.
Report one unit for the encounter when all five regions are manipulated; do not bill separate units for individual vertebrae or regions. Record each region treated and findings supporting care. For Medicare chiropractic coverage, document a spinal subluxation by x-ray or qualifying physical findings and use modifier AT for active corrective treatment; maintenance care is not covered. This procedure has a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for bilateral adjustments. CMS allows assistant-at-surgery payment only with 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 98942
Across 109 of 109 payment localities, the office rate for 98942 runs from $47.06 in Arkansas to $66.49 in Alaska. Iowa pays $48.03. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$48.03
- Los Angeles, CA · California$54.24+$6.21
- Washington, DC area · District of Columbia$54.71+$6.68
- Miami, FL · Florida$51.02+$2.99
- Chicago, IL · Illinois$50.51+$2.48
- Manhattan, NY · New York$54.89+$6.86
- Alaska · Alaska$66.49+$18.46
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $47.37 | $37.14 |
| ArkansasArkansas | $47.06 | $37.02 |
| ArizonaArizona | $49.16 | $37.83 |
| Bakersfield, CACalifornia | $51.96 | $39.15 |
| Chico, CACalifornia | $51.88 | $39.07 |
| El Centro, CACalifornia | $51.88 | $39.07 |
| Fresno, CACalifornia | $51.88 | $39.07 |
| Hanford, CACalifornia | $51.88 | $39.07 |
| Madera, CACalifornia | $51.88 | $39.07 |
| Merced, CACalifornia | $51.88 | $39.07 |
| Modesto, CACalifornia | $51.88 | $39.07 |
| Napa, CACalifornia | $57.32 | $41.91 |
| Oxnard, CACalifornia | $53.80 | $39.99 |
| Redding, CACalifornia | $51.88 | $39.07 |
| Rest of CaliforniaCalifornia | $51.88 | $39.07 |
| Riverside, CACalifornia | $52.01 | $39.20 |
| Sacramento, CACalifornia | $53.68 | $40.09 |
| Salinas, CACalifornia | $53.45 | $39.90 |
| San Diego, CACalifornia | $54.09 | $40.11 |
| Marin County, CACalifornia | $59.96 | $43.48 |
| San Francisco, CACalifornia | $59.95 | $43.47 |
| San Benito County, CACalifornia | $61.04 | $44.18 |
| Santa Clara County, CACalifornia | $60.99 | $44.13 |
| San Luis Obispo, CACalifornia | $52.65 | $39.34 |
| Santa Cruz, CACalifornia | $54.15 | $39.95 |
| Santa Maria, CACalifornia | $53.49 | $39.85 |
| Santa Rosa, CACalifornia | $54.67 | $40.31 |
| Stockton, CACalifornia | $51.88 | $39.07 |
| Vallejo, CACalifornia | $57.30 | $41.89 |
| Visalia, CACalifornia | $51.88 | $39.07 |
| Yuba City, CACalifornia | $51.88 | $39.07 |
| ColoradoColorado | $51.23 | $38.79 |
| ConnecticutConnecticut | $51.85 | $39.26 |
| DelawareDelaware | $49.67 | $38.12 |
| Fort Lauderdale, FLFlorida | $50.27 | $38.43 |
| Rest of FloridaFlorida | $49.14 | $37.97 |
| Atlanta, GAGeorgia | $50.22 | $38.34 |
| Rest of GeorgiaGeorgia | $47.88 | $37.46 |
| Hawaii, Guam, HIHawaii | $52.10 | $38.81 |
| IdahoIdaho | $48.15 | $37.39 |
| East St. Louis, ILIllinois | $48.66 | $37.91 |
| Rest of IllinoisIllinois | $48.39 | $37.71 |
| Suburban Chicago, ILIllinois | $50.73 | $38.73 |
| IndianaIndiana | $48.28 | $37.44 |
| KansasKansas | $47.87 | $37.30 |
| KentuckyKentucky | $47.74 | $37.34 |
| New Orleans, LALouisiana | $48.75 | $37.75 |
| Rest of LouisianaLouisiana | $47.68 | $37.33 |
| Metropolitan Boston, MAMassachusetts | $54.52 | $40.56 |
| Rest of MassachusettsMassachusetts | $51.16 | $38.85 |
| Baltimore area, MDMaryland | $51.67 | $39.12 |
| Rest of MarylandMaryland | $50.27 | $38.44 |
| Rest of MaineMaine | $48.20 | $37.44 |
| Southern Maine, MEMaine | $49.48 | $37.90 |
| Detroit, MIMichigan | $49.37 | $38.08 |
| Rest of MichiganMichigan | $48.24 | $37.57 |
| MinnesotaMinnesota | $50.06 | $38.03 |
| Metropolitan Kansas City, MOMissouri | $48.66 | $37.68 |
| Metropolitan St. Louis, MOMissouri | $48.90 | $37.77 |
| Rest of MissouriMissouri | $47.27 | $37.19 |
| MississippiMississippi | $47.17 | $37.11 |
| MontanaMontana | $49.77 | $38.08 |
| North CarolinaNorth Carolina | $48.44 | $37.53 |
| North DakotaNorth Dakota | $49.57 | $37.88 |
| NebraskaNebraska | $48.17 | $37.38 |
| New HampshireNew Hampshire | $50.47 | $38.30 |
| Northern New JerseyNew Jersey | $54.65 | $41.09 |
| Rest of New JerseyNew Jersey | $52.71 | $39.95 |
| New MexicoNew Mexico | $48.34 | $37.62 |
| NevadaNevada | $49.73 | $38.03 |
| NYC suburbs and Long Island, NYNew York | $55.47 | $41.57 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $52.96 | $40.16 |
| Queens, NYNew York | $55.21 | $41.39 |
| Rest of New YorkNew York | $48.77 | $37.66 |
| OhioOhio | $48.20 | $37.53 |
| OklahomaOklahoma | $47.76 | $37.32 |
| Portland, OROregon | $52.19 | $39.20 |
| Rest of OregonOregon | $49.60 | $37.95 |
| Metropolitan Philadelphia, PAPennsylvania | $51.14 | $38.97 |
| Rest of PennsylvaniaPennsylvania | $48.27 | $37.54 |
| Puerto RicoPuerto Rico | $49.96 | $38.14 |
| Rhode IslandRhode Island | $50.92 | $38.85 |
| South CarolinaSouth Carolina | $48.35 | $37.54 |
| South DakotaSouth Dakota | $49.55 | $37.86 |
| TennesseeTennessee | $47.97 | $37.34 |
| Austin, TXTexas | $50.84 | $38.47 |
| Beaumont, TXTexas | $48.12 | $37.48 |
| Brazoria, TXTexas | $49.78 | $38.20 |
| Dallas, TXTexas | $49.93 | $38.29 |
| Fort Worth, TXTexas | $49.75 | $38.23 |
| Galveston, TXTexas | $49.83 | $38.23 |
| Houston, TXTexas | $50.02 | $38.41 |
| Rest of TexasTexas | $48.82 | $37.72 |
| UtahUtah | $48.65 | $37.66 |
| VirginiaVirginia | $49.36 | $37.87 |
| Virgin Islands, VIUnited States Virgin Islands | $49.96 | $38.14 |
| VermontVermont | $49.42 | $37.85 |
| Rest of WashingtonWashington | $51.05 | $38.74 |
| King County, WAWashington | $55.37 | $41.03 |
| WisconsinWisconsin | $48.78 | $37.58 |
| West VirginiaWest Virginia | $47.55 | $37.39 |
| WyomingWyoming | $49.68 | $37.99 |
98942 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.
$47.06
$66.49
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 | $66.49 | 1 |
| AL | $47.37 | 1 |
| AR | $47.06 | 1 |
| AZ | $49.16 | 1 |
| CA | $51.88–$61.04 | 29 |
| CO | $51.23 | 1 |
| CT | $51.85 | 1 |
| DC | $54.71 | 1 |
| DE | $49.67 | 1 |
| FL | $49.14–$51.02 | 3 |
| GA | $47.88–$50.22 | 2 |
| GU | $52.10 | 1 |
| HI | $52.10 | 1 |
| IA | $48.03 | 1 |
| ID | $48.15 | 1 |
| IL | $48.39–$50.73 | 4 |
| IN | $48.28 | 1 |
| KS | $47.87 | 1 |
| KY | $47.74 | 1 |
| LA | $47.68–$48.75 | 2 |
| MA | $51.16–$54.52 | 2 |
| MD | $50.27–$54.71 | 3 |
| ME | $48.20–$49.48 | 2 |
| MI | $48.24–$49.37 | 2 |
| MN | $50.06 | 1 |
| MO | $47.27–$48.90 | 3 |
| MS | $47.17 | 1 |
| MT | $49.77 | 1 |
| NC | $48.44 | 1 |
| ND | $49.57 | 1 |
| NE | $48.17 | 1 |
| NH | $50.47 | 1 |
| NJ | $52.71–$54.65 | 2 |
| NM | $48.34 | 1 |
| NV | $49.73 | 1 |
| NY | $48.77–$55.47 | 5 |
| OH | $48.20 | 1 |
| OK | $47.76 | 1 |
| OR | $49.60–$52.19 | 2 |
| PA | $48.27–$51.14 | 2 |
| PR | $49.96 | 1 |
| RI | $50.92 | 1 |
| SC | $48.35 | 1 |
| SD | $49.55 | 1 |
| TN | $47.97 | 1 |
| TX | $48.12–$50.84 | 8 |
| UT | $48.65 | 1 |
| VA | $49.36–$54.71 | 2 |
| VI | $49.96 | 1 |
| VT | $49.42 | 1 |
| WA | $51.05–$55.37 | 2 |
| WI | $48.78 | 1 |
| WV | $47.55 | 1 |
| WY | $49.68 | 1 |
How the 98942 rate is calculated
Each of 98942’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 · 98942
RVUs × geographic indexes × conversion factor
Work0.94
0.94 RVUs× 1.000 GPCI
Practice expense0.54
0.54 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.4900
Conversion factor
$33.4009
Medicare rate
$49.77
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
12,944
- Code
- 98942
- Physician work
- 0.94
- Practice expense
- 0.54
- 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 | 0.94 | × 1.000 | 0.9400 |
| Practice expense | 0.54 | × 0.915 | 0.4941 |
| Malpractice | 0.01 | × 0.397 | 0.0040 |
| Total RVUs | 1.4381 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$48.03
Office: (0.94 × 1 + 0.54 × 0.915 + 0.01 × 0.397) × $33.4009 = $48.03
Facility: (0.94 × 1 + 0.19 × 0.915 + 0.01 × 0.397) × $33.4009 = $37.34
Payment rules and modifiers for 98942
The CMS indicators that decide how 98942 is paid alongside other services.
CMS payment indicators · 98942
Chiropractic adjustment, spinal, five 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 98942 has changed in Iowa
98942 · Office / nonfacility
$48.03
Effective 2026-10-01
The base rate is unchanged from 2025-10-01: $48.03 in both releases.
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
$48.03changed to$48.03
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.96 changed to 0.94
- Practice expense RVU 0.57 changed to 0.54
- 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
$48.82changed to$48.03
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.55 changed to 0.57
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$48.03changed to$48.82
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$49.95changed to$48.03
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.56 changed to 0.55
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$50.47changed to$49.95
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.54 changed to 0.56
- Malpractice RVU 0.02 changed to 0.01
- 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
$50.88changed to$50.47
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$51.97changed to$50.88
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.52 changed to 0.54
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$51.73changed to$51.97
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.51 changed to 0.52
- Malpractice RVU 0.03 changed to 0.02
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$52.00changed to$51.73
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.52 changed to 0.51
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$51.46changed to$52.00
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.51 changed to 0.52
- 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
$51.26changed to$51.46
- 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
$51.45changed to$51.26
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$51.19changed to$51.45
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$51.20changed to$51.19
- Conversion factor 35.8228 changed to 35.7547
- 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$51.20
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 | $48.03 | $37.34 | RVU26D |
| 2026-07-01 | $48.03 | $37.34 | RVU26C |
| 2026-04-01 | $48.03 | $37.34 | RVU26B |
| 2026-01-01 | $48.03 | $37.34 | RVU26A |
| 2025-10-01 | $48.03 | $42.72 | RVU25D |
| 2025-07-01 | $48.03 | $42.72 | RVU25C |
| 2025-04-01 | $48.03 | $42.72 | RVU25B |
| 2025-01-01 | $48.03 | $42.72 | RVU25A |
| 2024-10-01 | $48.82 | $43.35 | RVU24D |
| 2024-07-01 | $48.82 | $43.35 | RVU24C |
| 2024-04-01 | $48.82 | $43.35 | RVU24B |
| 2024-03-09 | $48.82 | $43.35 | RVU24AR |
| 2024-01-01 | $48.03 | $42.65 | RVU24A |
| 2023-10-01 | $49.95 | $44.40 | RVU23D |
| 2023-07-01 | $49.95 | $44.40 | RVU23C |
| 2023-04-01 | $49.95 | $44.40 | RVU23B |
| 2023-01-01 | $49.95 | $44.40 | RVU23A |
| 2022-10-01 | $50.47 | $44.82 | RVU22D |
| 2022-07-01 | $50.47 | $44.82 | RVU22C |
| 2022-04-01 | $50.47 | $44.82 | RVU22B |
| 2022-01-01 | $50.47 | $44.82 | RVU22A |
| 2021-10-01 | $50.88 | $45.19 | RVU21D |
| 2021-07-01 | $50.88 | $45.19 | RVU21C |
| 2021-04-01 | $50.88 | $45.19 | RVU21B |
| 2021-01-01 | $50.88 | $45.19 | RVU21A |
| 2020-10-01 | $51.97 | $46.41 | RVU20D |
| 2020-07-01 | $51.97 | $46.41 | RVU20C |
| 2020-04-01 | $51.97 | $46.41 | RVU20B |
| 2020-01-01 | $51.97 | $46.41 | RVU20A |
| 2019-10-01 | $51.73 | $46.17 | RVU19D |
| 2019-07-01 | $51.73 | $46.17 | RVU19C |
| 2019-04-01 | $51.73 | $46.17 | RVU19B |
| 2019-01-01 | $51.73 | $46.17 | RVU19A |
| 2018-10-01 | $52.00 | $46.12 | RVU18D |
| 2018-07-01 | $52.00 | $46.12 | RVU18C |
| 2018-04-01 | $52.00 | $46.12 | RVU18B |
| 2018-01-01 | $52.00 | $46.12 | RVU18AR1 |
| 2017-10-01 | $51.46 | $45.95 | RVU17D |
| 2017-07-01 | $51.46 | $45.95 | RVU17C |
| 2017-04-01 | $51.46 | $45.95 | RVU17B |
| 2017-01-01 | $51.46 | $45.95 | RVU17A |
| 2016-10-01 | $51.26 | $45.49 | RVU16D |
| 2016-07-01 | $51.26 | $45.49 | RVU16C |
| 2016-04-01 | $51.26 | $45.49 | RVU16B |
| 2016-01-01 | $51.26 | $45.49 | RVU16A |
| 2015-10-01 | $51.45 | $45.65 | RVU15D |
| 2015-07-01 | $51.45 | $45.65 | RVU15C |
| 2015-04-01 | $51.19 | $45.43 | RVU15B |
| 2015-01-01 | $51.19 | $45.43 | RVU15A |
| 2014-10-01 | $51.20 | $45.76 | RVU14D |
| 2014-07-01 | $51.20 | $45.76 | 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.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
98942 billing questions
How are the five spinal regions counted for this code?
The regions are cervical, thoracic, lumbar, sacral, and pelvic. Manipulation must be documented in all five; use 98941 if only three or four are manipulated.
When is modifier AT used on a Medicare claim?
Append AT when the manipulation is active corrective treatment of a documented spinal subluxation. Medicare does not cover maintenance manipulation.
Can an E/M visit be billed on the same day?
Same-day preoperative and postoperative care is included in the 0-day global period. Medicare does not pay chiropractors separately for E/M services; an eligible clinician reporting a significant, separately identifiable E/M service places modifier 25 on the E/M code.
Can an extremity adjustment be reported with five-region spinal manipulation?
Code 98943 may be reported for a separately documented extraspinal adjustment when payer coverage allows. Medicare does not cover extraspinal manipulation furnished by chiropractors.
Can 97140 be reported for manual therapy on the same date?
Manual therapy to the same anatomical region is not separately reportable with this manipulation. For a payer that covers both services, a distinct site may support separate reporting with modifier 59 or XS when the documentation and applicable edit permit it; Medicare does not cover 97140 furnished by a chiropractor.
What documentation supports billing this level?
List each of the five regions manipulated and the findings supporting treatment. For a Medicare claim, document the spinal subluxation, active treatment, and applicable treatment plan.
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
Fee sheets
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