Billing code 98928: Osteopathic manipulationMedicare rate & RVUs
Reports physician-performed osteopathic manipulation when manual treatment addresses somatic dysfunction in seven or eight distinct body regions during the encounter.
Medicare pays $73.48 for 98928 nationally in the office and $50.10 in a hospital or facility. Local office rates run $67.87–$94.20.
Medicare rate · 98928
Osteopathic manipulation
Swap in your local Medicare rate.
- Work RVUs
- 1.18
- Total RVUs
- 2.20
- Global days
- 000
National rate · 2026
$73.48
Office setting, before claim adjustments.
See every locality for 98928 → · Billed by an NP, PA or therapist? →
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 10 sections
What 98928 covers
This service represents osteopathic manipulative treatment directed at somatic dysfunction in seven or eight body regions. A physician, commonly a doctor of osteopathic medicine, uses hands-on techniques to treat the affected regions. The regions counted are the head, cervical, thoracic, lumbar, sacral, pelvic, lower-extremity, upper-extremity, and rib-cage areas. Treatment may occur in an office or facility setting.
Select this level based on the distinct regions actually treated, not simply the regions examined or noted as dysfunctional. The record should identify the treated regions and support that manipulation was performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for bilateral adjustment. 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.
Where 98928 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$67.87 to $94.20
109 of 109 payment localities
98928 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
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$67.87
$94.20
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 | $94.20 | 1 |
| AL | $68.50 | 1 |
| AR | $67.87 | 1 |
| AZ | $72.16 | 1 |
| CA | $76.11–$90.76 | 29 |
| CO | $75.47 | 1 |
| CT | $77.20 | 1 |
| DC | $81.52 | 1 |
| DE | $73.06 | 1 |
| FL | $73.26–$78.36 | 3 |
| GA | $70.50–$74.58 | 2 |
| GU | $76.84 | 1 |
| HI | $76.84 | 1 |
| IA | $69.38 | 1 |
| ID | $69.71 | 1 |
| IL | $72.04–$76.94 | 4 |
| IN | $69.96 | 1 |
| KS | $69.28 | 1 |
| KY | $69.76 | 1 |
| LA | $69.73–$71.93 | 2 |
| MA | $75.32–$81.00 | 2 |
| MD | $74.07–$81.52 | 3 |
| ME | $70.06–$72.33 | 2 |
| MI | $71.02–$73.98 | 2 |
| MN | $72.76 | 1 |
| MO | $69.04–$71.96 | 3 |
| MS | $68.46 | 1 |
| MT | $73.48 | 1 |
| NC | $70.51 | 1 |
| ND | $72.09 | 1 |
| NE | $69.58 | 1 |
| NH | $74.49 | 1 |
| NJ | $78.20–$81.20 | 2 |
| NM | $71.32 | 1 |
| NV | $73.12 | 1 |
| NY | $71.20–$84.01 | 5 |
| OH | $70.74 | 1 |
| OK | $69.57 | 1 |
| OR | $72.66–$77.04 | 2 |
| PA | $70.75–$75.94 | 2 |
| PR | $73.80 | 1 |
| RI | $75.03 | 1 |
| SC | $70.72 | 1 |
| SD | $71.93 | 1 |
| TN | $69.51 | 1 |
| TX | $70.46–$75.13 | 8 |
| UT | $71.34 | 1 |
| VA | $72.26–$81.52 | 2 |
| VI | $73.80 | 1 |
| VT | $72.01 | 1 |
| WA | $75.12–$82.23 | 2 |
| WI | $70.53 | 1 |
| WV | $70.33 | 1 |
| WY | $72.87 | 1 |
How the 98928 rate is calculated
Each of 98928’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 · 98928
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.18Practice expense 0.95Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 98928
The CMS indicators that decide how 98928 is paid alongside other services.
CMS payment indicators · 98928
Osteopathic manipulation
| 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. |
98928 compared with similar codes
Compare codes
98928 vs 98927 vs 98929 vs 98941: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 98927Osteopathic manipulation
- Use 98927 when manipulation treats five or six body regions. Use 98928 when it treats seven or eight.
- 98929Osteopathic manipulation
- Use 98929 for manipulation of nine or ten body regions; 98928 covers seven or eight.
- 98941Chiropractic adjustment
- 98941 is a chiropractic manipulative treatment code for three or four spinal regions. This code represents osteopathic manipulative treatment counted by body regions.
98928 billing questions
How do I choose this code instead of 98927 or 98929?
Count the distinct body regions that received osteopathic manipulation. Use 98928 for seven or eight treated regions; 98927 represents five or six, and 98929 represents nine or ten.
Do regions that were only examined count toward the level?
No. The level is based on regions treated with manipulation, so documentation should distinguish those regions from areas that were only evaluated.
Can I append modifier 50 for treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What is included in the 0-day global period?
Same-day preoperative and postoperative care is included in the service under CMS's 0-day global-period rule.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment is limited to cases with documented medical necessity. Co-surgeons and team surgery are not permitted under the CMS rules supplied for this code.
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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