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.
In New Mexico, Medicare pays $88.11 for 99234 in a facility. There’s no office rate.
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.
On this page 11 sections
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.
- New Mexico · this page$88.11
- Los Angeles, CA · California$91.71+$3.60
- Washington, DC area · District of Columbia$95.20+$7.09
- Miami, FL · Florida$98.00+$9.89
- Chicago, IL · Illinois$96.51+$8.40
- Manhattan, NY · New York$98.47+$10.36
- Alaska · Alaska$119.88+$31.77
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | — | $88.00 |
| Merced, CACalifornia | — | $88.00 |
| Modesto, CACalifornia | — | $88.00 |
| Napa, CACalifornia | — | $94.31 |
| Oxnard, CACalifornia | — | $90.58 |
| Redding, CACalifornia | — | $88.00 |
| Rest of CaliforniaCalifornia | — | $88.00 |
| Riverside, CACalifornia | — | $89.97 |
| Sacramento, CACalifornia | — | $90.30 |
| Salinas, CACalifornia | — | $89.90 |
| San Diego, CACalifornia | — | $90.44 |
| Marin County, CACalifornia | — | $97.57 |
| San Francisco, CACalifornia | — | $97.37 |
| San Benito County, CACalifornia | — | $99.53 |
| Santa Clara County, CACalifornia | — | $98.69 |
| San Luis Obispo, CACalifornia | — | $88.66 |
| Santa Cruz, CACalifornia | — | $90.09 |
| Santa Maria, CACalifornia | — | $89.81 |
| Santa Rosa, CACalifornia | — | $90.90 |
| Stockton, CACalifornia | — | $88.00 |
| Vallejo, CACalifornia | — | $94.02 |
| Visalia, CACalifornia | — | $88.00 |
| Yuba City, CACalifornia | — | $88.00 |
| ColoradoColorado | — | $88.65 |
| ConnecticutConnecticut | — | $91.96 |
| DelawareDelaware | — | $87.72 |
| Fort Lauderdale, FLFlorida | — | $93.24 |
| Rest of FloridaFlorida | — | $90.53 |
| Atlanta, GAGeorgia | — | $89.83 |
| Rest of GeorgiaGeorgia | — | $87.67 |
| Hawaii, Guam, HIHawaii | — | $87.75 |
| IowaIowa | — | $83.25 |
| IdahoIdaho | — | $83.78 |
| East St. Louis, ILIllinois | — | $93.05 |
| Rest of IllinoisIllinois | — | $90.23 |
| Suburban Chicago, ILIllinois | — | $93.70 |
| IndianaIndiana | — | $83.97 |
| KansasKansas | — | $83.72 |
| KentuckyKentucky | — | $85.96 |
| New Orleans, LALouisiana | — | $88.09 |
| Rest of LouisianaLouisiana | — | $86.16 |
| Metropolitan Boston, MAMassachusetts | — | $93.24 |
| Rest of MassachusettsMassachusetts | — | $88.84 |
| Baltimore area, MDMaryland | — | $91.79 |
| Rest of MarylandMaryland | — | $88.54 |
| Rest of MaineMaine | — | $84.68 |
| Southern Maine, MEMaine | — | $85.82 |
| Detroit, MIMichigan | — | $91.76 |
| Rest of MichiganMichigan | — | $87.62 |
| MinnesotaMinnesota | — | $84.39 |
| Metropolitan Kansas City, MOMissouri | — | $87.10 |
| Metropolitan St. Louis, MOMissouri | — | $87.45 |
| Rest of MissouriMissouri | — | $85.90 |
| MississippiMississippi | — | $84.47 |
| MontanaMontana | — | $88.17 |
| North CarolinaNorth Carolina | — | $84.98 |
| North DakotaNorth Dakota | — | $84.61 |
| NebraskaNebraska | — | $83.26 |
| New HampshireNew Hampshire | — | $88.06 |
| Northern New JerseyNew Jersey | — | $95.25 |
| Rest of New JerseyNew Jersey | — | $92.85 |
| NevadaNevada | — | $87.19 |
| NYC suburbs and Long Island, NYNew York | — | $100.51 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $93.91 |
| Queens, NYNew York | — | $97.91 |
| Rest of New YorkNew York | — | $85.62 |
| OhioOhio | — | $86.89 |
| OklahomaOklahoma | — | $85.19 |
| Portland, OROregon | — | $89.41 |
| Rest of OregonOregon | — | $86.33 |
| Metropolitan Philadelphia, PAPennsylvania | — | $91.17 |
| Rest of PennsylvaniaPennsylvania | — | $86.59 |
| Puerto RicoPuerto Rico | — | $88.26 |
| Rhode IslandRhode Island | — | $89.31 |
| South CarolinaSouth Carolina | — | $86.11 |
| South DakotaSouth Dakota | — | $84.19 |
| TennesseeTennessee | — | $84.00 |
| Austin, TXTexas | — | $88.52 |
| Beaumont, TXTexas | — | $86.37 |
| Brazoria, TXTexas | — | $87.25 |
| Dallas, TXTexas | — | $87.86 |
| Fort Worth, TXTexas | — | $87.79 |
| Galveston, TXTexas | — | $87.57 |
| Houston, TXTexas | — | $90.87 |
| Rest of TexasTexas | — | $86.81 |
| UtahUtah | — | $86.64 |
| VirginiaVirginia | — | $86.15 |
| Virgin Islands, VIUnited States Virgin Islands | — | $88.26 |
| VermontVermont | — | $85.05 |
| Rest of WashingtonWashington | — | $88.42 |
| King County, WAWashington | — | $93.91 |
| WisconsinWisconsin | — | $83.37 |
| West VirginiaWest Virginia | — | $88.76 |
| WyomingWyoming | — | $86.62 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.00 | × 1.000 | 2.0000 |
| Practice expense | 0.46 | × 0.917 | 0.4218 |
| Malpractice | 0.18 | × 1.201 | 0.2162 |
| Total RVUs | 2.6380 | ||
| 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
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.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $88.11 | RVU26D |
| 2026-07-01 | Not available in this setting | $88.11 | RVU26C |
| 2026-04-01 | Not available in this setting | $88.11 | RVU26B |
| 2026-01-01 | Not available in this setting | $88.11 | RVU26A |
| 2025-10-01 | Not available in this setting | $92.49 | RVU25D |
| 2025-07-01 | Not available in this setting | $92.49 | RVU25C |
| 2025-04-01 | Not available in this setting | $92.49 | RVU25B |
| 2025-01-01 | Not available in this setting | $92.49 | RVU25A |
| 2024-10-01 | Not available in this setting | $95.27 | RVU24D |
| 2024-07-01 | Not available in this setting | $95.27 | RVU24C |
| 2024-04-01 | Not available in this setting | $95.27 | RVU24B |
| 2024-03-09 | Not available in this setting | $95.27 | RVU24AR |
| 2024-01-01 | Not available in this setting | $93.72 | RVU24A |
| 2023-10-01 | Not available in this setting | $97.52 | RVU23D |
| 2023-07-01 | Not available in this setting | $97.52 | RVU23C |
| 2023-04-01 | Not available in this setting | $97.52 | RVU23B |
| 2023-01-01 | Not available in this setting | $97.52 | RVU23A |
| 2022-10-01 | Not available in this setting | $128.17 | RVU22D |
| 2022-07-01 | Not available in this setting | $128.17 | RVU22C |
| 2022-04-01 | Not available in this setting | $128.17 | RVU22B |
| 2022-01-01 | Not available in this setting | $128.17 | RVU22A |
| 2021-10-01 | Not available in this setting | $129.13 | RVU21D |
| 2021-07-01 | Not available in this setting | $129.13 | RVU21C |
| 2021-04-01 | Not available in this setting | $129.13 | RVU21B |
| 2021-01-01 | Not available in this setting | $129.13 | RVU21A |
| 2020-10-01 | Not available in this setting | $134.31 | RVU20D |
| 2020-07-01 | Not available in this setting | $134.31 | RVU20C |
| 2020-04-01 | Not available in this setting | $134.31 | RVU20B |
| 2020-01-01 | Not available in this setting | $134.31 | RVU20A |
| 2019-10-01 | Not available in this setting | $134.11 | RVU19D |
| 2019-07-01 | Not available in this setting | $134.11 | RVU19C |
| 2019-04-01 | Not available in this setting | $134.11 | RVU19B |
| 2019-01-01 | Not available in this setting | $134.11 | RVU19A |
| 2018-10-01 | Not available in this setting | $134.62 | RVU18D |
| 2018-07-01 | Not available in this setting | $134.62 | RVU18C |
| 2018-04-01 | Not available in this setting | $134.62 | RVU18B |
| 2018-01-01 | Not available in this setting | $134.62 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $133.86 | RVU17D |
| 2017-07-01 | Not available in this setting | $133.86 | RVU17C |
| 2017-04-01 | Not available in this setting | $133.86 | RVU17B |
| 2017-01-01 | Not available in this setting | $133.86 | RVU17A |
| 2016-10-01 | Not available in this setting | $133.21 | RVU16D |
| 2016-07-01 | Not available in this setting | $133.21 | RVU16C |
| 2016-04-01 | Not available in this setting | $133.21 | RVU16B |
| 2016-01-01 | Not available in this setting | $133.21 | RVU16A |
| 2015-10-01 | Not available in this setting | $134.10 | RVU15D |
| 2015-07-01 | Not available in this setting | $134.10 | RVU15C |
| 2015-04-01 | Not available in this setting | $133.44 | RVU15B |
| 2015-01-01 | Not available in this setting | $133.44 | RVU15A |
| 2014-10-01 | Not available in this setting | $133.37 | RVU14D |
| 2014-07-01 | Not available in this setting | $133.37 | RVU14C |
| 2014-04-01 | Not available in this setting | $133.37 | RVU14B |
| 2014-01-01 | Not available in this setting | $133.37 | RVU14A |
| 2013-10-01 | Not available in this setting | $128.22 | RVU13D |
| 2013-07-01 | Not available in this setting | $128.22 | RVU13C |
| 2013-04-01 | Not available in this setting | $128.22 | RVU13B |
| 2013-01-01 | Not available in this setting | $128.22 | RVU13AR |
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
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
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