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See a sample rate comparisonCPT 98943 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Chiropractic Manipulative Trea, Chiropractic Manipulative Treatment (Cmt) Extraspinal One Or More Regions Chiropractic Manipulative Treatment (Cmt) Extraspinal One
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Chiropractic Manipulative Treatment Procedures |
| Common Place of Service | 11 - Office 49 - Independent Clinic |
| Common Modifiers | 59 - Distinct Procedural Service AT - Acute or Active Treatment |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 98943 |
| Medicaid Fee Schedule | $22.64 median of the 8 states in the free preview · View Medicaid rates for 98943 |
National average reimbursement for CPT 98943 by major payers:
$24.25
$30.15
$25.59
$35.21
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CPT 98943
5 of 25 sample ratesHigher to lower in this preview
John Millichap
Multicare Health System
$60.91Published rateRebecca O'Donnell
$53.27Published rateMy Phon Nguyen
Mount Sinai Community Foundation
$30.67Published rateAmber Kazi
Presence Healthcare Services
$26.93Published rateJocelyn Lorenzo
$11.72Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 98943 vs. Other Chiropractic Manipulative Treatment Procedures Codes
The CPT 98943 code is part of the Medicine Services and Procedures services used for Chiropractic Manipulative Treatment Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 98943 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 98940-CPT | Low | Chiropractic Adjustment, Chiropractic Services To Treat One To Five Areas Of The Spine. The Areas Are Moved Gently To Encourage The Body To Realign Itself. |
| 98941-CPT | Low | Chiropractic Manipulative Trea, Chiropractic Manipulative Treatment (Cmt) Spinalthree To Four Regions Chiropractic Manipulative Treatment (Cmt) Spinal Three To |
| 98942-CPT | Low | Chiropractic Adjustment, Chiropractic Services To Treat One To Five Areas Of The Spine. The Areas Are Moved Gently To Encourage The Body To Realign Itself. |
| 98943-CPT | Low | Chiropractic Manipulative Trea, Chiropractic Manipulative Treatment (Cmt) Extraspinal One Or More Regions Chiropractic Manipulative Treatment (Cmt) Extraspinal One |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 98943. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98943 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services to payers for reimbursement. Each CPT code corresponds to a specific service or procedure, ensuring consistent communication across the healthcare industry.
To find the cost of a specific medical procedure, you can use its CPT code. For an accurate estimate tailored to your specific situation and location, it's recommended to use a fee schedule lookup tool. Payerprice offers a tool where you can search with a CPT code and your specific location to find relevant pricing information. This can help you understand potential costs before your procedure.
Yes, medical procedure costs can vary significantly based on location, the specific healthcare provider (e.g., hospital vs. outpatient clinic), and even the payer (insurance company). Factors like regional cost of living, facility fees, and negotiated rates all contribute to these variations. Tools like Payerprice can help you compare costs for CPT codes in different locations.
The final price you pay for a medical service is influenced by several factors, including the CPT code for the service, your specific insurance plan (deductibles, co-pays, co-insurance), whether the provider is in-network or out-of-network, the facility where the service is performed, and your geographic location. It's important to understand your insurance benefits and use tools like Payerprice to get an estimate of the provider's charges.
Payerprice provides a fee schedule lookup tool that allows you to search for medical procedure costs using CPT codes and your specific location. This tool can help you compare prices, understand the typical charges for various services, and make more informed decisions about your healthcare. By providing transparent pricing information, Payerprice helps users navigate the complexities of healthcare expenses.