CPT code 98942: Chiropractic adjustment, spinal, five regions2026 Medicare rate & RVUs in New Mexico

Report chiropractic spinal manipulation at this level when treatment is documented in all five regions: cervical, thoracic, lumbar, sacral, and pelvic.

CMS RVU26DEffective Oct 1, 2026One payment locality983K Medicare services in 2024

In New Mexico, Medicare pays $48.34 for 98942 in the office and $37.62 when it’s performed in a hospital or facility.

$48.34Office (non-facility)
$37.62Hospital or facility
−2.9%vs the national office rate ($49.77)

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.

We’ll open 98942 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 98942 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 New Mexico 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. New Mexico pays $48.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

98942 in New Mexico vs other payment areas
  1. New Mexico · this page$48.34
  2. Los Angeles, CA · California$54.24+$5.90
  3. Washington, DC area · District of Columbia$54.71+$6.37
  4. Miami, FL · Florida$51.02+$2.68
  5. Chicago, IL · Illinois$50.51+$2.17
  6. Manhattan, NY · New York$54.89+$6.55
  7. Alaska · Alaska$66.49+$18.15

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

98942 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
98942 office rate range by state
State / territoryOffice rate rangeLocalities
AK$66.491
AL$47.371
AR$47.061
AZ$49.161
CA$51.88–$61.0429
CO$51.231
CT$51.851
DC$54.711
DE$49.671
FL$49.14–$51.023
GA$47.88–$50.222
GU$52.101
HI$52.101
IA$48.031
ID$48.151
IL$48.39–$50.734
IN$48.281
KS$47.871
KY$47.741
LA$47.68–$48.752
MA$51.16–$54.522
MD$50.27–$54.713
ME$48.20–$49.482
MI$48.24–$49.372
MN$50.061
MO$47.27–$48.903
MS$47.171
MT$49.771
NC$48.441
ND$49.571
NE$48.171
NH$50.471
NJ$52.71–$54.652
NM$48.341
NV$49.731
NY$48.77–$55.475
OH$48.201
OK$47.761
OR$49.60–$52.192
PA$48.27–$51.142
PR$49.961
RI$50.921
SC$48.351
SD$49.551
TN$47.971
TX$48.12–$50.848
UT$48.651
VA$49.36–$54.712
VI$49.961
VT$49.421
WA$51.05–$55.372
WI$48.781
WV$47.551
WY$49.681

See 98942 in every payment locality

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

Office or facility?

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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 98942 in New Mexico
ComponentRVULocality factorAdjusted
Physician work0.94× 1.0000.9400
Practice expense0.54× 0.9170.4952
Malpractice0.01× 1.2010.0120
Total RVUs1.4472
Conversion factor× 33.4009

Office rate, New Mexico$48.34

Office: (0.94 × 1 + 0.54 × 0.917 + 0.01 × 1.201) × $33.4009 = $48.34

Facility: (0.94 × 1 + 0.19 × 0.917 + 0.01 × 1.201) × $33.4009 = $37.62

Open 98942 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 98942 has changed in New Mexico

98942 · Office / nonfacility

$48.34

Effective 2026-10-01

The base rate is $0.17 higher than on 2025-10-01, moving from $48.17 to $48.34 (0.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $48.17changed to$48.34

    • 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 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $48.97changed to$48.17

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.55 changed to 0.57

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $48.17changed to$48.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $50.04changed to$48.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.56 changed to 0.55
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $50.77changed to$50.04

    • 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 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $51.19changed to$50.77

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $52.56changed to$51.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.52 changed to 0.54
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $52.87changed to$52.56

    • 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
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $53.15changed to$52.87

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.52 changed to 0.51

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $52.59changed to$53.15

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.51 changed to 0.52
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $52.40changed to$52.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $52.59changed to$52.40

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $52.33changed to$52.59

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $52.32changed to$52.33

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. July 1, 2014

    RVU14C

    No ratechanged to$52.32

    Held through RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$48.34$37.62RVU26D
2026-07-01$48.34$37.62RVU26C
2026-04-01$48.34$37.62RVU26B
2026-01-01$48.34$37.62RVU26A
2025-10-01$48.17$42.89RVU25D
2025-07-01$48.17$42.89RVU25C
2025-04-01$48.17$42.89RVU25B
2025-01-01$48.17$42.89RVU25A
2024-10-01$48.97$43.53RVU24D
2024-07-01$48.97$43.53RVU24C
2024-04-01$48.97$43.53RVU24B
2024-03-09$48.97$43.53RVU24AR
2024-01-01$48.17$42.82RVU24A
2023-10-01$50.04$44.54RVU23D
2023-07-01$50.04$44.54RVU23C
2023-04-01$50.04$44.54RVU23B
2023-01-01$50.04$44.54RVU23A
2022-10-01$50.77$45.19RVU22D
2022-07-01$50.77$45.19RVU22C
2022-04-01$50.77$45.19RVU22B
2022-01-01$50.77$45.19RVU22A
2021-10-01$51.19$45.57RVU21D
2021-07-01$51.19$45.57RVU21C
2021-04-01$51.19$45.57RVU21B
2021-01-01$51.19$45.57RVU21A
2020-10-01$52.56$46.99RVU20D
2020-07-01$52.56$46.99RVU20C
2020-04-01$52.56$46.99RVU20B
2020-01-01$52.56$46.99RVU20A
2019-10-01$52.87$47.23RVU19D
2019-07-01$52.87$47.23RVU19C
2019-04-01$52.87$47.23RVU19B
2019-01-01$52.87$47.23RVU19A
2018-10-01$53.15$47.18RVU18D
2018-07-01$53.15$47.18RVU18C
2018-04-01$53.15$47.18RVU18B
2018-01-01$53.15$47.18RVU18AR1
2017-10-01$52.59$46.98RVU17D
2017-07-01$52.59$46.98RVU17C
2017-04-01$52.59$46.98RVU17B
2017-01-01$52.59$46.98RVU17A
2016-10-01$52.40$46.48RVU16D
2016-07-01$52.40$46.48RVU16C
2016-04-01$52.40$46.48RVU16B
2016-01-01$52.40$46.48RVU16A
2015-10-01$52.59$46.65RVU15D
2015-07-01$52.59$46.65RVU15C
2015-04-01$52.33$46.41RVU15B
2015-01-01$52.33$46.41RVU15A
2014-10-01$52.32$46.73RVU14D
2014-07-01$52.32$46.73RVU14C
2014-04-01Additional calculation requiredAdditional calculation requiredRVU14B
2014-01-01Additional calculation requiredAdditional calculation requiredRVU14A
2013-10-01Additional calculation requiredAdditional calculation requiredRVU13D
2013-07-01Additional calculation requiredAdditional calculation requiredRVU13C
2013-04-01Additional calculation requiredAdditional calculation requiredRVU13B
2013-01-01Additional calculation requiredAdditional calculation requiredRVU13AR

Price 98942 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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
RVUs for 98942PPRRVU2026_Oct_nonQPP.csv, line 12,944 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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