CPT code 98942: Chiropractic adjustment, spinal, five regions2026 Medicare rate & RVUs in Oregon
Report chiropractic spinal manipulation at this level when treatment is documented in all five regions: cervical, thoracic, lumbar, sacral, and pelvic.
Medicare pays $49.60–$52.19 for 98942 in the office in Oregon, from Rest of Oregon to Portland, OR. 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 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.
Where 98942 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | $52.19 | $39.20 |
| Rest of Oregon | $49.60 | $37.95 |
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.
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. |
98942 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 98941Chiropractic adjustmentSpinal, 3-4 regions
- Use 98941 when three or four spinal regions are manipulated. Code 98942 requires documented manipulation in all five: cervical, thoracic, lumbar, sacral, and pelvic.
- 98927Osteopathic manipulationFive to six regions
- Code 98927 is osteopathic manipulative treatment of five or six body regions. Code 98942 is chiropractic manipulative treatment of all five spinal regions.
- 98943Extraspinal manipulationOne or more regions
- Code 98943 covers manipulation of extraspinal areas such as an extremity or the TMJ. Code 98942 covers spinal regions; both may be reported when both services are furnished and payer coverage allows.
- 97140Manual therapyOne or more regions, each 15 minutes
- Code 97140 describes timed manual therapy rather than chiropractic spinal manipulation. Therapy to the same anatomical region is not separately reportable; Medicare does not cover 97140 furnished by a chiropractor.
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
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