$40.09–$47.43
Choose 98941 when three or four spinal regions are adjusted at the visit; 98940 covers one or two.
On this page
CMS RVU26D · Effective 2026-10-01
98940 Chiropractic adjustment Medicare reimbursement rates in California
Report chiropractic spinal manipulation of one or two regions when those regions are adjusted during an encounter to treat a documented spinal subluxation. Compare 98940 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 98940 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$27.91–$33.24
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $5.33 per service.
Facility setting
$18.76–$21.20
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $2.44 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 98940 pays more and less in California
29 payment localities
$27.91 to $33.24
Chiropractic manipulative treatment
About 98940: Chiropractic spinal manipulation, one to two regions
Report chiropractic spinal manipulation of one or two regions when those regions are adjusted during an encounter to treat a documented spinal subluxation.
This service involves chiropractic adjustment of one or two of the five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. A patient with low back pain might receive treatment in the lumbar and pelvic regions; a patient with neck pain might receive treatment in the cervical region. Doctors of chiropractic typically perform the service in an office. For Medicare coverage of care furnished by a chiropractor, the manipulation must be directed at correcting a spinal subluxation.
Count distinct regions adjusted, not individual vertebral segments; manipulation of three or four regions is reported with 98941. Medicare requires evidence of subluxation by x-ray or physical examination. Examination findings use PART: pain or tenderness, asymmetry or misalignment, range-of-motion abnormality, and tissue or tone change. Document the regions treated, findings, treatment plan, and progress; append modifier AT for active or corrective treatment, not maintenance care. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. CMS permits assistant-at-surgery payment only with documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 98940
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.45 · 56%
- Practice expense (office) RVU0.34 · 43%
- Malpractice RVU0.01 · 1%
3.7M
Medicare services in 2024 · #50 by national volume
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.
98940 compared with similar codes
Office rates for California, from the same CMS release.
$33.76–$40.82
98925 describes osteopathic manipulation of one or two body regions, which may include regions outside the spine. 98940 describes chiropractic manipulation counted across five spinal regions.
98943
No office rateChiropract manj xtrspinl 1/>
98943 covers extraspinal regions, such as extremities or the rib cage. 98940 covers one or two spinal regions.
Compare 98940 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $27.97 | Facility $18.81 |
| Chico | Office $27.91 | Facility $18.76 |
| El Centro | Office $27.91 | Facility $18.76 |
| Fresno | Office $27.91 | Facility $18.76 |
| Hanford-Corcoran | Office $27.91 | Facility $18.76 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $29.30 | Facility $19.42 |
| Madera | Office $27.91 | Facility $18.76 |
| Merced | Office $27.91 | Facility $18.76 |
| Modesto | Office $27.91 | Facility $18.76 |
| Napa | Office $31.11 | Facility $20.11 |
| Oxnard-Thousand Oaks-Ventura | Office $29.08 | Facility $19.21 |
| Redding | Office $27.91 | Facility $18.76 |
| Rest Of California | Office $27.91 | Facility $18.76 |
| Riverside-San Bernardino-Ontario | Office $28.03 | Facility $18.88 |
| Sacramento-Roseville-Folsom | Office $28.96 | Facility $19.25 |
| Salinas | Office $28.84 | Facility $19.16 |
| San Diego-Chula Vista-Carlsbad | Office $29.24 | Facility $19.26 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $32.62 | Facility $20.85 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $32.61 | Facility $20.84 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $33.24 | Facility $21.20 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $33.19 | Facility $21.15 |
| San Luis Obispo-Paso Robles | Office $28.40 | Facility $18.89 |
| Santa Cruz-Watsonville | Office $29.32 | Facility $19.18 |
| Santa Maria-Santa Barbara | Office $28.87 | Facility $19.14 |
| Santa Rosa-Petaluma | Office $29.61 | Facility $19.35 |
| Stockton | Office $27.91 | Facility $18.76 |
| Vallejo | Office $31.10 | Facility $20.09 |
| Visalia | Office $27.91 | Facility $18.76 |
| Yuba City | Office $27.91 | Facility $18.76 |
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98940 billing questions
How are spinal regions counted to choose between 98940 and 98941?
Count the regions actually adjusted among cervical, thoracic, lumbar, sacral, and pelvic. One or two regions is 98940; three or four is 98941. Multiple vertebral levels within one region count as one region.
When is modifier AT required?
Medicare expects AT when chiropractic manipulation is active or corrective treatment of a subluxation. Without AT, Medicare treats the claim as maintenance therapy; AT alone does not establish medical necessity.
Can a chiropractor bill a separate E/M visit on the same day?
Medicare does not separately pay chiropractors for E/M visits. The routine assessment before manipulation and same-day postoperative care are included in 98940.
What documentation supports subluxation for Medicare?
Subluxation must be demonstrated by x-ray or physical examination. The examination route requires at least two PART elements, including asymmetry or misalignment or a range-of-motion abnormality; document the treatment plan and measurable goals.
Can 98940 be billed with extraspinal manipulation?
98943 describes manipulation of extraspinal regions, such as an extremity or the rib cage, and may be reported when separately performed. Medicare does not cover chiropractic extraspinal manipulation furnished by a chiropractor.
Should modifier 50 be used if both sides of the spine are adjusted?
No. Report 98940 once for manipulation of one or two spinal regions during the encounter, regardless of which sides are treated; modifier 50 is inappropriate.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,93998927,,Osteopath manj 5-6 regions,A,,0.94,0.82,,0.20,,0.06,1.82,1.20,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94098928,,Osteopath manj 7-8 regions,A,,1.18,0.95,,0.25,,0.07,2.20,1.50,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94198929,,Osteopath manj 9-10 regions,A,,1.42,1.08,,0.29,,0.07,2.57,1.78,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94298940,,Chiropract manj 1-2 regions,A,,0.45,0.34,,0.09,,0.01,0.80,0.55,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94398941,,Chiropract manj 3-4 regions,A,,0.69,0.45,,0.14,,0.01,1.15,0.84,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94498942,,Chiropractic manj 5 regions,A,,0.94,0.54,,0.19,,0.01,1.49,1.14,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94598943,,Chiropract manj xtrspinl 1/>,N,+,0.45,0.31,,0.10,,0.03,0.79,0.58,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00