CPT 98928
Global 000 ActiveOsteopath manj 7-8 regions
CPT 98928 Billing & Documentation Guide
CPT code 98928 (Osteopath manj 7-8 regions) is classified under Osteopathic with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.18, a non-facility practice expense RVU of 0.95, and a malpractice RVU of 0.07, a total non-facility RVU of 2.2 and facility RVU of 1.5. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $75.33, though rates vary from $67.87 to $94.2 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 98928, 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 98928 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 98928 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 98928
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.18 | 1.18 |
| Practice Expense RVU | 0.95 | 0.25 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 2.2 | 1.5 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 98928
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 | $79.64 | $51.97 | $76.11 - $90.76 | 29 |
| Florida | $75.8 | $52.34 | $73.26 - $78.36 | 3 |
| Georgia | $72.54 | $50.24 | $70.5 - $74.58 | 2 |
| Illinois | $74.68 | $52.09 | $72.04 - $76.94 | 4 |
| Michigan | $72.5 | $50.55 | $71.02 - $73.98 | 2 |
| North Carolina | $70.51 | $48.7 | $70.51 - $70.51 | 1 |
| New York | $79.86 | $53.78 | $71.2 - $84.01 | 5 |
| Ohio | $70.74 | $49.39 | $70.74 - $70.74 | 1 |
| Pennsylvania | $73.35 | $50.45 | $70.75 - $75.94 | 2 |
| Texas | $73.04 | $50.02 | $70.46 - $75.13 | 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 98928
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 98928 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 98928
What does CPT code 98928 mean? +
CPT code 98928 represents: Osteopath manj 7-8 regions. It's in the Osteopathic category with a global period of 000.
What is the Medicare reimbursement for CPT 98928? +
The 2026 Medicare national average non-facility payment for CPT 98928 is $75.33. Rates range from $67.87 to $94.2 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 98928? +
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 98928? +
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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