CPT 98926
Global 000 ActiveOsteopath manj 3-4 regions
CPT 98926 Billing & Documentation Guide
CPT code 98926 (Osteopath manj 3-4 regions) is classified under Osteopathic with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.69, a non-facility practice expense RVU of 0.65, and a malpractice RVU of 0.04, a total non-facility RVU of 1.38 and facility RVU of 0.89. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $47.32, though rates vary from $42.38 to $58.43 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 98926, 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 98926 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 98926 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 98926
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.69 | 0.69 |
| Practice Expense RVU | 0.65 | 0.16 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 1.38 | 0.89 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 98926
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 | $50.29 | $30.92 | $47.95 - $57.6 | 29 |
| Florida | $47.43 | $31.01 | $45.81 - $49.03 | 3 |
| Georgia | $45.39 | $29.78 | $44.01 - $46.78 | 2 |
| Illinois | $46.66 | $30.84 | $44.96 - $48.09 | 4 |
| Michigan | $45.32 | $29.95 | $44.38 - $46.25 | 2 |
| North Carolina | $44.16 | $28.89 | $44.16 - $44.16 | 1 |
| New York | $50.18 | $31.92 | $44.61 - $52.82 | 5 |
| Ohio | $44.22 | $29.27 | $44.22 - $44.22 | 1 |
| Pennsylvania | $45.95 | $29.92 | $44.24 - $47.66 | 2 |
| Texas | $45.79 | $29.68 | $44.04 - $47.25 | 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 98926
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 98926 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 98926
What does CPT code 98926 mean? +
CPT code 98926 represents: Osteopath manj 3-4 regions. It's in the Osteopathic category with a global period of 000.
What is the Medicare reimbursement for CPT 98926? +
The 2026 Medicare national average non-facility payment for CPT 98926 is $47.32. Rates range from $42.38 to $58.43 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 98926? +
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 98926? +
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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