CPT code 98942: Chiropractic adjustment, spinal, five regions2026 Medicare rate & RVUs in Chicago, IL

In Chicago, IL, Medicare pays $50.51 for 98942 in the office and $38.76 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.

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 Chicago, IL 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. Chicago, IL pays $50.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

98942 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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.

Payment rules and modifiers for 98942

The CMS indicators that decide how 98942 is paid alongside other services.

Codes related to 98942

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 98942 has changed in Chicago, IL

Price 98942 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

• 98942 in Chicago · multiple payment areas
• Alsip
• Arlington Heights
• 98942 in Barrington · multiple payment areas
• 98942 in Barrington Hills · multiple payment areas
• 98942 in Bartlett · multiple payment areas
• Bedford Park
• Bellwood

Browse all communities in Illinois

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

Open CMS sourceHow we calculate rates