Medicare & Medicaid in New Mexico (NM)
2026 healthcare costs, coverage, and spending data for New Mexico.
$8,073
Spending/Capita
2,510,430
Medicare Enrollees
3,380,574
Medicaid Enrollees
7.1%
Uninsured Rate
Medicare Premiums in New Mexico
Part B Premium
$185/mo
Part D Premium (Avg)
$79/mo
Medigap Premium (Avg)
$209/mo
Medicaid Expansion: Yes - New Mexico expanded Medicaid under the ACA
Procedure Costs in New Mexico
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $208,513 | $166,810 | $41,703 |
| Kidney Transplant | $142,568 | $114,054 | $28,514 |
| Heart Valve Replacement | $61,002 | $48,801 | $12,200 |
| Coronary Artery Bypass Graft (CABG) | $58,373 | $46,699 | $11,675 |
| Spinal Fusion | $49,723 | $39,778 | $9,945 |
| Defibrillator Implantation (ICD) | $40,438 | $32,350 | $8,088 |
| Total Knee Replacement | $39,228 | $31,383 | $7,846 |
| Total Hip Replacement | $35,539 | $28,431 | $7,108 |
| Pacemaker Implantation | $29,478 | $23,582 | $5,896 |
| Hip Fracture Repair | $28,270 | $22,616 | $5,654 |
| Sepsis Treatment | $26,596 | $21,277 | $5,319 |
| Laminectomy | $24,910 | $19,928 | $4,982 |
| Carotid Endarterectomy | $23,676 | $18,941 | $4,735 |
| Mastectomy | $22,929 | $18,343 | $4,586 |
| Prostatectomy | $21,390 | $17,112 | $4,278 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $8,287 | $6,629 | $1,657 |
| Endoscopic Sinus Surgery | $7,881 | $6,305 | $1,576 |
| Lithotripsy (Kidney Stones) | $7,468 | $5,974 | $1,494 |
| Dialysis Access Surgery | $7,108 | $5,686 | $1,422 |
| TURP (Prostate) | $6,902 | $5,521 | $1,380 |
| Bunionectomy | $6,853 | $5,483 | $1,371 |
| Tonsillectomy | $5,741 | $4,592 | $1,148 |
| Septoplasty | $4,635 | $3,708 | $927 |
| Cataract Surgery (Outpatient) | $4,242 | $3,394 | $848 |
| Nasal Polyp Removal | $4,234 | $3,387 | $847 |
| Hemorrhoid Surgery | $3,831 | $3,064 | $766 |
| Carpal Tunnel Release | $3,725 | $2,980 | $745 |
| Ganglion Cyst Removal | $3,617 | $2,893 | $723 |
| Adenoidectomy | $3,450 | $2,760 | $690 |
| Breast Biopsy | $3,333 | $2,666 | $667 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,552 | $2,842 | $710 |
| CT Angiography | $1,729 | $1,383 | $346 |
| MRI Spine (Lumbar) | $1,688 | $1,350 | $338 |
| Nuclear Stress Test | $1,638 | $1,310 | $328 |
| MRI Hip | $1,438 | $1,151 | $288 |
| MRI Spine (Cervical) | $1,438 | $1,150 | $288 |
| MRI Brain | $1,141 | $912 | $228 |
| CT Scan Abdomen/Pelvis | $1,083 | $867 | $217 |
| MRI Knee | $1,028 | $823 | $206 |
| MRI Shoulder | $1,019 | $815 | $204 |
| Bone Scan | $987 | $790 | $197 |
| CT Colonography (Virtual) | $879 | $703 | $176 |
| CT Scan Head | $850 | $680 | $170 |
| CT Scan Chest | $828 | $662 | $166 |
| Echocardiogram | $583 | $466 | $117 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Allergy Testing | $354 | $283 | $71 |
| Sleep Study Consultation | $285 | $228 | $57 |
| Psychiatry Visit | $284 | $227 | $57 |
| Mammogram (Screening) | $253 | $253 | $0 |
| Annual Wellness Visit | $247 | $247 | $0 |
| Shingles Vaccination | $221 | $221 | $0 |
| Office Visit (New Patient) | $202 | $162 | $40 |
| Bone Density Test (DEXA Scan) | $187 | $150 | $37 |
| Skin Cancer Screening | $186 | $149 | $37 |
| Mental Health Counseling | $182 | $145 | $36 |
| Office Visit (Established Patient) | $172 | $137 | $34 |
| Speech Therapy Session | $166 | $133 | $33 |
| Physical Therapy Session | $157 | $125 | $31 |
| Wound Care Visit | $153 | $122 | $31 |
| EKG (Electrocardiogram) | $130 | $104 | $26 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Blood Type and Crossmatch | $62 | $49 | $12 |
| Blood Culture | $60 | $48 | $12 |
| Vitamin D Level | $49 | $39 | $10 |
| Troponin Level | $49 | $39 | $10 |
| BNP (Heart Failure Marker) | $49 | $39 | $10 |
| Thyroid Panel (TSH) | $47 | $38 | $9 |
| PSA (Prostate-Specific Antigen) | $47 | $38 | $9 |
| Comprehensive Metabolic Panel | $41 | $33 | $8 |
| Glucose Tolerance Test | $38 | $31 | $8 |
| Complete Blood Count (CBC) | $37 | $30 | $7 |
| Iron Studies (Ferritin) | $36 | $29 | $7 |
| Hemoglobin A1C | $35 | $28 | $7 |
| Liver Function Panel | $35 | $28 | $7 |
| Lipid Panel | $35 | $28 | $7 |
| Urine Drug Screen | $32 | $26 | $6 |
Compare New Mexico With Other States
Frequently Asked Questions
How much does Medicare spend per person in New Mexico?
In 2026, the average Medicare spending per beneficiary in New Mexico is $8,073.
How many people are enrolled in Medicare in New Mexico?
New Mexico has approximately 2,510,430 Medicare beneficiaries.
Did New Mexico expand Medicaid?
Yes, New Mexico expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in New Mexico?
The uninsured rate in New Mexico is 7.1%.
What is the average Medigap premium in New Mexico?
The average Medigap (Medicare Supplement) premium in New Mexico is $209 per month.