How much does Medicare pay for CPT 98927?

Medicare allowed an average of $57.47 per service and paid $43.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $139.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 98927?

Osteopathic manipulative treatment, 5-6 body regions. It was billed 64,841 times to 18,344 Medicare beneficiaries by 546 providers in 2024.

Does 98927 pay differently in an office than a hospital?

Yes. The allowed amount averaged $58.03 in an office setting and $48.20 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 98927 most?

Family Practice, with 22,747 services from 255 clinicians. Next are Osteopathic Manipulative Medicine, Physical Medicine and Rehabilitation, Internal Medicine.

CPT 98927

Osteopathic manipulative treatment, 5-6 body regions

$57.47Medicare-allowed amount per service, averaged across 64,841 services

Providers submitted

$139.12

Asking price, not received

Medicare allowed

$57.47

The fee schedule figure

Medicare paid

$43.70

Balance is patient coinsurance

Providers submitted an average of $139.12 for this code and Medicare allowed $57.47 — 2.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $43.70 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $58.03
Hospital / facility: $48.20

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 61,165 services were billed in an office setting and 3,676 in a facility.

Services: 64,841
Beneficiaries: 18,344
Providers billing it: 546
Total allowed: $3,726,412

What Medicare pays for CPT 98927

Across 64,841 services billed by 546 providers to 18,344 beneficiaries, Medicare allowed an average of $57.47 per service. That is 3.5 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 98927

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	22,747	7,030	$58.38	255
Osteopathic Manipulative Medicine	19,622	6,051	$57.25	146
Physical Medicine and Rehabilitation	6,709	1,831	$60.67	52
Internal Medicine	5,667	1,163	$59.34	27
Nurse Practitioner	2,804	506	$46.76	11
Physician Assistant	1,938	230	$48.41	11
Pain Management	1,426	105	$58.59	2
Sports Medicine	1,193	457	$55.95	15
General Practice	983	448	$58.78	10
Interventional Pain Management	750	137	$55.86	3
Obstetrics & Gynecology	309	137	$59.16	2
Emergency Medicine	172	47	$48.75	2
Neurology	127	22	$62.34	1
Geriatric Medicine	85	27	$59.35	1
Psychiatry	79	36	$55.02	1

98927 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	10,993	$63.71	$44.59	49
California	6,769	$62.51	$43.83	59
Florida	5,622	$56.81	$44.17	22
Michigan	3,597	$53.59	$41.55	46
Texas	3,312	$50.34	$39.82	27
New Jersey	3,105	$61.26	$44.26	23
Arizona	3,105	$50.69	$40.47	24
Ohio	2,365	$52.57	$41.12	22
Massachusetts	2,043	$60.76	$42.12	15
Pennsylvania	1,976	$58.51	$42.80	20
Missouri	1,834	$54.05	$42.47	16
Colorado	1,742	$54.89	$41.54	15
Oregon	1,670	$56.18	$42.41	18
New Hampshire	1,504	$58.27	$40.47	7
Minnesota	1,410	$56.13	$42.81	6
Virginia	1,318	$53.95	$42.15	15
Maine	1,279	$50.81	$39.29	22
Alaska	1,191	$66.63	$38.27	10
Wisconsin	1,107	$52.84	$39.87	14
Oklahoma	1,036	$51.90	$41.70	15
Kentucky	1,032	$50.88	$40.39	14
Iowa	1,008	$50.17	$39.98	13
Washington	765	$57.20	$41.46	12
Illinois	635	$56.57	$41.74	9
Indiana	544	$54.56	$42.57	9
District of Columbia	528	$64.33	$44.64	1
Connecticut	510	$59.95	$43.11	8
Vermont	415	$56.59	$43.51	2
Hawaii	395	$56.36	$42.26	3
North Carolina	376	$51.05	$39.92	4
New Mexico	277	$55.51	$42.25	4
Montana	262	$51.87	$39.70	4
Arkansas	164	$54.02	$43.29	2
Maryland	130	$56.51	$41.00	2
Nevada	124	$50.12	$40.08	1
Kansas	118	$54.40	$41.67	1
Tennessee	111	$45.99	$35.62	2
Idaho	91	$53.17	$44.52	1
Georgia	75	$57.71	$45.88	1
Louisiana	60	$44.63	$34.81	1
North Dakota	48	$56.99	$40.82	1
Alabama	40	$48.27	$39.04	1
Utah	40	$55.80	$42.52	1
Guam	39	$60.13	$42.26	1
West Virginia	29	$43.72	$34.47	1
Delaware	25	$44.89	$32.82	1
Wyoming	22	$57.18	$43.79	1

Related codes

98941Chiropractic manipulative treatment$38.12
98940Chiropractic manipulative treatment$26.75
98942Chiropractic manipulative treatment$49.84
98977Device supply$48.07
98976Device supply$48.79
98980Remote therapeutic monitoring treatment management services by physici$49.72
98929Osteopathic manipulative treatment$83.31
98928Osteopathic manipulative treatment$70.48
98926Osteopathic manipulative treatment$43.00
98981Remote therapeutic monitoring treatment management services by physici$38.72
98975Set-up and patient education for remote monitoring of therapy$20.19
98925Osteopathic manipulative treatment$30.48

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.