New Mexico · G0498

Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in New Mexico

New Mexico Medicare Avg
$124.35
16% below national avg
National Medicare Avg
$148.58
All states combined
Billed Charge (NM)
$687.05
What providers submit
Est. Commercial (NM)
$334.78
National avg: $419.65
Est. Cash / Self-Pay (NM)
$305.72
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

419
Services in NM
23
Providers
N/A
Min Payment
N/A
Max Payment

New Mexico Pricing in Context

In New Mexico, CPT code G0498 (Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L) carries an average Medicare payment of $124.35 — 16% below the national benchmark of $148.58. 23 providers across the state submitted claims for this procedure in 2023, performing 419 total services. Individual payments in NM ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in New Mexico is $687.05, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because New Mexico sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Temporary Procedures procedures, the estimated commercial insurance price in New Mexico lands near $334.78, with self-pay cash prices typically around $305.72. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cost in New Mexico?

The average Medicare payment for Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in New Mexico is $124.35, which is 16% below the national average of $148.58. Providers in NM typically bill $687.05 for this procedure.

What does Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cost with insurance in New Mexico?

With commercial insurance in New Mexico, Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L costs an estimated $334.78. Without insurance, the estimated cash price is $305.72. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in New Mexico?

23 providers in New Mexico billed Medicare for Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L in 2023, performing 419 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L cheaper in New Mexico than the national average?

Yes — Chemotherapy Administration, Intravenous Infusion Technique; Initiation Of Infusion In The Office/clinic Setting Using Office/clinic Pump/supplies, With Continuation Of The Infusion In The Community Setting (e.g., Home, Domiciliary, Rest Home Or Assisted L costs 16% below the national average in New Mexico. The state average Medicare payment is $124.35 compared to $148.58 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial