$44.24–$47.66
Use 98926 when OMT treats three or four distinct body regions; use this code when five or six are treated.
On this page
CMS RVU26D · Effective 2026-10-01
98927 Osteopathic manipulation Medicare reimbursement rates in Pennsylvania
Report this OMT service when a clinician manually treats somatic dysfunction in five or six defined body regions during one encounter. Compare 98927 office and facility rates across CMS payment localities in Pennsylvania.
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 98927 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$58.43–$62.86
2 of 2 localities have a supported rate.
Facility setting
$39.42–$41.31
2 of 2 localities have a supported rate.
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.
Osteopathic treatment
About 98927: Osteopathic manipulation, five to six regions
Report this OMT service when a clinician manually treats somatic dysfunction in five or six defined body regions during one encounter.
This service represents osteopathic manipulative treatment directed to somatic dysfunction in five or six body regions. An osteopathic physician, commonly a DO, may use manual techniques such as soft-tissue mobilization, muscle energy, or articulatory treatment in an office or outpatient setting. The defined regions include areas such as the cervical, thoracic, lumbar, sacral, pelvic, rib cage, and extremity regions; count the regions treated, not the number of techniques or individual structures addressed.
Select the code from the number of distinct regions actually treated, and document the dysfunction findings and treatment for those regions. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate for bilateral adjustment. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 98927
- 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 RVU0.94 · 52%
- Practice expense (office) RVU0.82 · 45%
- Malpractice RVU0.06 · 3%
80.9K
Medicare services in 2024 · #627 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.
98927 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$70.75–$75.94
Use 98928 when OMT treats seven or eight distinct body regions; this code is for five or six.
$48.27–$51.14
98942 describes chiropractic spinal manipulation involving five spinal regions. This code counts five or six defined regions treated with OMT.
Compare 98927 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$62.86
Facility
$41.31
Rest Of Pennsylvania →
Office / nonfacility
$58.43
Facility
$39.42
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
98927 billing questions
How does this code differ from 98926 or 98928?
Choose among these OMT codes by the number of distinct body regions treated: 98926 covers three or four, this code covers five or six, and 98928 covers seven or eight.
What should the note document?
Record the somatic dysfunction findings and the specific body regions treated, with enough detail to support that five or six distinct regions received OMT.
Can modifier 50 be used when both sides are treated?
No. Bilateral adjustment is not appropriate for this code, even when treatment involves paired structures.
Is same-day evaluation or follow-up care included?
The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
Does the region count refer to techniques or body areas?
It refers to distinct defined body regions treated, not the number of manual techniques or individual structures addressed.
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.
12,93698016,,Brief comunicaj tech-bsd svc,A,,0.30,0.20,,0.07,,0.02,0.52,0.39,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93798925,,Osteopath manj 1-2 regions,A,,0.45,0.49,,0.11,,0.03,0.97,0.59,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93898926,,Osteopath manj 3-4 regions,A,,0.69,0.65,,0.16,,0.04,1.38,0.89,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93998927,,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