CPT code 99234: Hospital care, same-day admission and discharge2026 Medicare rate & RVUs in New Mexico

Reports hospital inpatient or observation evaluation and management when the patient is admitted and discharged on the same date at a straightforward or low level.

CMS RVU26DEffective Oct 1, 2026One payment locality21K Medicare services in 2024

In New Mexico, Medicare pays $88.11 for 99234 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$88.11Hospital or facility

Check a contract rate as a % of Medicare · 99234 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99234 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 99234 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99234 covers

A physician or other qualified health care professional reports 99234 for hospital inpatient or observation care when the patient is admitted and discharged on the same calendar date. The encounter combines the admission evaluation and discharge-day management into one service. A typical setting is a hospital observation unit evaluating a stable symptom or condition with a same-day disposition; the code level depends on the documented service, not the diagnosis alone.

Select the code based on straightforward or low medical decision making, or on at least 45 minutes of qualifying total time on the date of the encounter. Documentation should support the admission, the same-day discharge, and the medical decision making or time used to select the level. Report one combined service rather than separating the same-day care into an initial hospital-care code and a discharge-management code.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How New Mexico compares for 99234

Across 109 of 109 payment localities, the facility rate for 99234 runs from $83.10 in Arkansas to $119.88 in Alaska. New Mexico pays $88.11. The RVUs are the same everywhere; the geographic indexes change the dollars.

99234 in New Mexico vs other payment areas
  1. New Mexico · this page$88.11
  2. Los Angeles, CA · California$91.71+$3.60
  3. Washington, DC area · District of Columbia$95.20+$7.09
  4. Miami, FL · Florida$98.00+$9.89
  5. Chicago, IL · Illinois$96.51+$8.40
  6. Manhattan, NY · New York$98.47+$10.36
  7. Alaska · Alaska$119.88+$31.77

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

99234 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$83.65
ArkansasArkansas—$83.10
ArizonaArizona—$86.84
Bakersfield, CACalifornia—$88.57
Chico, CACalifornia—$88.00
El Centro, CACalifornia—$88.03
Fresno, CACalifornia—$88.00
Hanford, CACalifornia—$88.00

99234 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
99234 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 99234 in every payment locality

How the 99234 rate is calculated

Each of 99234’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99234

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.00

2.00 RVUs× 1.000 GPCI

Practice expense0.46

0.46 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

2.6400

Conversion factor

$33.4009

Medicare rate

$88.18

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,024

Code
99234
Physician work
2.00
Practice expense
0.46
Malpractice
0.18

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 99234 in New Mexico
ComponentRVULocality factorAdjusted
Physician work2.00× 1.0002.0000
Practice expense0.46× 0.9170.4218
Malpractice0.18× 1.2010.2162
Total RVUs2.6380
Conversion factor× 33.4009

Facility rate, New Mexico$88.11

Facility: (2 × 1 + 0.46 × 0.917 + 0.18 × 1.201) × $33.4009 = $88.11

Open 99234 in the RVU calculator

Payment rules and modifiers for 99234

99234 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99234

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

99234 isn’t priced in this setting.

How 99234 has changed in New Mexico

99234 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$88.11RVU26D
2026-07-01Not available in this setting$88.11RVU26C
2026-04-01Not available in this setting$88.11RVU26B
2026-01-01Not available in this setting$88.11RVU26A
2025-10-01Not available in this setting$92.49RVU25D
2025-07-01Not available in this setting$92.49RVU25C
2025-04-01Not available in this setting$92.49RVU25B
2025-01-01Not available in this setting$92.49RVU25A
2024-10-01Not available in this setting$95.27RVU24D
2024-07-01Not available in this setting$95.27RVU24C
2024-04-01Not available in this setting$95.27RVU24B
2024-03-09Not available in this setting$95.27RVU24AR
2024-01-01Not available in this setting$93.72RVU24A
2023-10-01Not available in this setting$97.52RVU23D
2023-07-01Not available in this setting$97.52RVU23C
2023-04-01Not available in this setting$97.52RVU23B
2023-01-01Not available in this setting$97.52RVU23A
2022-10-01Not available in this setting$128.17RVU22D
2022-07-01Not available in this setting$128.17RVU22C
2022-04-01Not available in this setting$128.17RVU22B
2022-01-01Not available in this setting$128.17RVU22A
2021-10-01Not available in this setting$129.13RVU21D
2021-07-01Not available in this setting$129.13RVU21C
2021-04-01Not available in this setting$129.13RVU21B
2021-01-01Not available in this setting$129.13RVU21A
2020-10-01Not available in this setting$134.31RVU20D
2020-07-01Not available in this setting$134.31RVU20C
2020-04-01Not available in this setting$134.31RVU20B
2020-01-01Not available in this setting$134.31RVU20A
2019-10-01Not available in this setting$134.11RVU19D
2019-07-01Not available in this setting$134.11RVU19C
2019-04-01Not available in this setting$134.11RVU19B
2019-01-01Not available in this setting$134.11RVU19A
2018-10-01Not available in this setting$134.62RVU18D
2018-07-01Not available in this setting$134.62RVU18C
2018-04-01Not available in this setting$134.62RVU18B
2018-01-01Not available in this setting$134.62RVU18AR1
2017-10-01Not available in this setting$133.86RVU17D
2017-07-01Not available in this setting$133.86RVU17C
2017-04-01Not available in this setting$133.86RVU17B
2017-01-01Not available in this setting$133.86RVU17A
2016-10-01Not available in this setting$133.21RVU16D
2016-07-01Not available in this setting$133.21RVU16C
2016-04-01Not available in this setting$133.21RVU16B
2016-01-01Not available in this setting$133.21RVU16A
2015-10-01Not available in this setting$134.10RVU15D
2015-07-01Not available in this setting$134.10RVU15C
2015-04-01Not available in this setting$133.44RVU15B
2015-01-01Not available in this setting$133.44RVU15A
2014-10-01Not available in this setting$133.37RVU14D
2014-07-01Not available in this setting$133.37RVU14C
2014-04-01Not available in this setting$133.37RVU14B
2014-01-01Not available in this setting$133.37RVU14A
2013-10-01Not available in this setting$128.22RVU13D
2013-07-01Not available in this setting$128.22RVU13C
2013-04-01Not available in this setting$128.22RVU13B
2013-01-01Not available in this setting$128.22RVU13AR

Price 99234 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

99234 billing questions

When is 99234 appropriate?

Use it when the patient receives hospital inpatient or observation care and is both admitted and discharged on the same calendar date, at a straightforward or low level.

Can time determine the code level?

Yes. The physician or qualified health care professional may select the level by total time on the encounter date; at least 45 minutes supports 99234.

Should admission and discharge be reported separately?

No. 99234 represents the combined same-day admission and discharge service; do not split that service into separate initial-care and discharge-management codes.

What if the patient stays overnight?

99234 is for admission and discharge on the same date. For a stay spanning dates, report the applicable hospital-care services for the separate dates instead.

What documentation supports 99234?

Document the hospital inpatient or observation encounter, admission and discharge dates, and the medical decision making or qualifying total time supporting the selected level.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99234PPRRVU2026_Oct_nonQPP.csv, line 13,024 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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