New Mexico

What Medicare pays in New Mexico

Billed charges against Medicare allowed amounts in New Mexico, across the 244 procedures Medicare covers most often.

244Procedures
6,136,328Services covered
3.0xBilled vs allowed
#35Rank of 61

Providers here billed the most above the national figure for removal of cataract with insertion of prosthetic lens. The average was $1,984.38 against a national $1,027.76. That is 1.9 times as much.

Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

The 40 most common procedures in New Mexico

ProcedureBilled hereAllowedGapvs national billed
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$231.06$107.112.2x0.84x
Ground mileage, per statute mile$14.04$9.621.5x0.53x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$168.04$77.212.2x0.89x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$59.98$21.302.8x0.87x
Therapy procedure using functional activities$69.61$28.442.4x0.93x
Fixed wing air mileage, per statute mile$137.88$15.209.1x0.99x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$63.34$25.002.5x0.87x
Insertion of needle into vein for collection of blood sample$24.57$8.602.9x1.13x
Destruction of precancer skin growth, 2-14 growths$16.63$5.613.0x0.76x
Therapy procedure using manual technique, each 15 minutes$55.95$19.592.9x0.83x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$199.05$72.992.7x0.98x
Rotary wing air mileage, per statute mile$333.84$41.178.1x0.93x
Blood test, comprehensive group of blood chemicals$45.64$10.314.4x0.74x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$38.31$7.585.1x1.03x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$328.83$151.762.2x0.81x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$33.13$7.724.3x0.74x
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's$39.04$15.392.5x0.90x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$323.35$109.942.9x0.99x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$344.57$144.032.4x0.84x
Chiropractic manipulative treatment, 3-4 spinal regions$63.46$36.791.7x1.05x
Pathology examination of tissue using a microscope, intermediate complexity$150.62$43.203.5x0.81x
Professional service for preparation and provision of 1 or more antigens$27.81$12.882.2x0.94x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$185.57$89.172.1x0.88x
Psychotherapy, 1 hour$195.64$117.511.7x0.94x
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$98.35$54.841.8x0.87x
Admn sarscov2 vacc 1 dose$41.28$32.841.3x0.82x
Administration of influenza virus vaccine$33.37$26.591.3x0.82x
Blood test, lipids (cholesterol and triglycerides)$74.16$13.065.7x0.77x
Established patient complete exam of visual system$204.31$114.631.8x0.90x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$238.18$95.742.5x0.90x
X-ray of chest, 1 view$43.10$8.325.2x0.82x
Emergency department visit with high level of medical decision making$1,322.21$166.987.9x1.07x
Blood test, thyroid stimulating hormone (tsh)$70.73$16.424.3x0.74x
Test for allergy using allergenic extract$17.45$3.205.5x1.32x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$232.77$113.852.0x0.84x
Hemoglobin a1c level$36.00$9.393.8x0.62x
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$107.88$46.722.3x0.92x
Destruction of precancer skin growth, 1 growth$154.93$46.073.4x1.00x
Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg$0.83$0.711.2x0.35x
Screening mammography$340.79$73.164.7x1.37x

The last column compares this state against the national average for the same code. Above 1.00 means providers here billed more.

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

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