How much does Medicare pay for CPT 98928?

Medicare allowed an average of $70.48 per service and paid $53.65 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $145.03, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 98928?

Osteopathic manipulative treatment, 7-8 body regions. It was billed 72,565 times to 17,300 Medicare beneficiaries by 485 providers in 2024.

Does 98928 pay differently in an office than a hospital?

Yes. The allowed amount averaged $71.01 in an office setting and $58.94 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 98928 most?

Family Practice, with 30,863 services from 221 clinicians. Next are Osteopathic Manipulative Medicine, Internal Medicine, Physical Medicine and Rehabilitation.

CPT 98928

Osteopathic manipulative treatment, 7-8 body regions

$70.48Medicare-allowed amount per service, averaged across 72,565 services

Providers submitted

$145.03

Asking price, not received

Medicare allowed

$70.48

The fee schedule figure

Medicare paid

$53.65

Balance is patient coinsurance

Providers submitted an average of $145.03 for this code and Medicare allowed $70.48 — 2.1× 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 $53.65 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $71.01
Hospital / facility: $58.94

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. 69,409 services were billed in an office setting and 3,156 in a facility.

Services: 72,565
Beneficiaries: 17,300
Providers billing it: 485
Total allowed: $5,114,381

What Medicare pays for CPT 98928

Across 72,565 services billed by 485 providers to 17,300 beneficiaries, Medicare allowed an average of $70.48 per service. That is 4.2 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 98928

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	30,863	7,495	$71.03	221
Osteopathic Manipulative Medicine	22,922	6,050	$68.89	162
Internal Medicine	8,709	1,243	$75.28	26
Physical Medicine and Rehabilitation	3,160	959	$69.49	36
Pain Management	2,710	248	$68.12	2
Sports Medicine	1,282	448	$70.14	11
General Practice	997	339	$69.43	8
Nurse Practitioner	849	141	$59.17	4
Interventional Pain Management	348	95	$74.29	3
Physician Assistant	195	54	$64.41	3
Emergency Medicine	194	96	$59.37	3
Undefined Physician type	106	46	$69.57	1
Neurology	74	21	$75.69	1
Obstetrics & Gynecology	71	27	$69.18	1
Hospice and Palliative Care	41	13	$72.55	1

98928 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
California	11,421	$77.88	$54.00	50
New York	9,718	$76.02	$54.32	45
Florida	8,254	$68.64	$53.38	37
Michigan	5,120	$68.99	$52.33	47
Maine	4,923	$66.07	$51.10	39
Texas	4,776	$65.88	$52.32	16
Virginia	3,490	$65.73	$52.10	11
New Mexico	2,641	$67.91	$54.36	4
Missouri	2,278	$65.60	$51.71	18
Massachusetts	1,814	$70.33	$51.68	18
New Jersey	1,514	$75.80	$54.07	20
Colorado	1,357	$70.84	$52.33	15
Washington	1,341	$68.86	$51.47	12
Montana	1,275	$66.07	$52.41	7
Nevada	1,234	$69.90	$53.70	2
Oregon	1,231	$68.44	$53.99	16
Ohio	1,231	$62.88	$48.22	16
Pennsylvania	1,043	$67.66	$50.42	9
Iowa	1,014	$66.36	$49.48	9
Arizona	995	$67.35	$53.23	12
Illinois	650	$68.68	$50.15	8
Tennessee	553	$64.01	$50.08	4
Kentucky	517	$61.06	$49.23	11
Oklahoma	482	$65.60	$50.44	10
New Hampshire	387	$68.84	$47.98	5
Alaska	329	$84.21	$48.32	7
Kansas	313	$71.25	$49.51	3
Vermont	308	$69.01	$52.40	2
Connecticut	303	$73.38	$52.87	4
West Virginia	266	$68.66	$53.45	2
Indiana	243	$66.31	$54.86	3
Nebraska	240	$63.15	$54.94	1
North Carolina	209	$60.25	$45.83	3
Rhode Island	182	$72.08	$51.96	2
Wisconsin	146	$65.48	$52.30	3
Minnesota	140	$66.76	$50.74	2
North Dakota	126	$69.44	$52.00	1
Maryland	119	$72.61	$52.58	2
Hawaii	82	$73.23	$50.56	2
Arkansas	79	$61.14	$56.42	1
Idaho	62	$66.59	$51.85	1
Georgia	48	$70.51	$50.30	1
Alabama	41	$65.34	$53.28	1
South Carolina	26	$67.31	$49.79	1
Utah	24	$68.09	$55.03	1
Delaware	20	$56.70	$45.08	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
98926Osteopathic manipulative treatment$43.00
98927Osteopathic manipulative treatment$57.47
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.