CPT 98925
Global 000 ActiveOsteopath manj 1-2 regions
CPT 98925 Billing & Documentation Guide
CPT code 98925 (Osteopath manj 1-2 regions) is classified under Osteopathic with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.45, a non-facility practice expense RVU of 0.49, and a malpractice RVU of 0.03, a total non-facility RVU of 0.97 and facility RVU of 0.59. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $33.28, though rates vary from $29.61 to $40.82 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 98925, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 98925 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 98925 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 98925
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.45 | 0.45 |
| Practice Expense RVU | 0.49 | 0.11 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 0.97 | 0.59 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 98925
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $35.48 | $20.46 | $33.76 - $40.82 | 29 |
| Florida | $33.4 | $20.67 | $32.18 - $34.6 | 3 |
| Georgia | $31.87 | $19.76 | $30.82 - $32.91 | 2 |
| Illinois | $32.81 | $20.55 | $31.54 - $33.88 | 4 |
| Michigan | $31.81 | $19.9 | $31.1 - $32.51 | 2 |
| North Carolina | $30.94 | $19.1 | $30.94 - $30.94 | 1 |
| New York | $35.36 | $21.2 | $31.28 - $37.31 | 5 |
| Ohio | $30.98 | $19.39 | $30.98 - $30.98 | 1 |
| Pennsylvania | $32.27 | $19.84 | $31 - $33.53 | 2 |
| Texas | $32.16 | $19.66 | $30.85 - $33.26 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 98925
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 98925 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00640 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0216T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0228T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0229T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0230T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0231T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36400 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36405 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 98925
What does CPT code 98925 mean? +
CPT code 98925 represents: Osteopath manj 1-2 regions. It's in the Osteopathic category with a global period of 000.
What is the Medicare reimbursement for CPT 98925? +
The 2026 Medicare national average non-facility payment for CPT 98925 is $33.28. Rates range from $29.61 to $40.82 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 98925? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 98925? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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