{
    "code": "98942",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/98942/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/98942/2021/C",
    "description": "Manual chiropractic adjustment covering all five recognised spinal regions in a single session: neck, upper back, mid back, lower back, and the pelvis and sacrum. It sits at the top of a three-code family that is graded entirely by region count. Because it claims the whole spine, the documentation is expected to establish a genuine problem in every one of the five regions.",
    "answer": {
        "question": "How much did Medicare pay for CPT 98942 in Q3 2021?",
        "text": "Medicare paid $53.04 for CPT 98942 in the office (non-facility) setting and $46.76 in a facility under the Q3 2021 Physician Fee Schedule, effective July 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2021, when it decreased 2.0%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "C",
        "label": "Q3 2021",
        "effective": "July 1 – September 30, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 53.04,
        "facility": 46.76,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.96,
        "practice_expense_non_facility": 0.54,
        "practice_expense_facility": 0.36,
        "malpractice": 0.02
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q3 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21c-updated-6302021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/C",
        "file": "PPRRVU21_JUL.csv",
        "row": 17166,
        "sha256": "ee14b5306942acfe4554d2d7cf3fe95d7b1a0f41fc7a0445bc2d06df857dd7b6"
    },
    "modified_at": "2026-08-04T03:10:45+00:00"
}