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Medicare Physician Fee Schedule · Q3 2026 release

CPT 76536 in Albuquerque, NM 04212-05

Neck soft-tissue ultrasound in ZIPs including 87102, 87501, and 87104

76536 2026 C · Albuquerque, NM flag04212-05 A Active
Non-facility Facility
Allowed amount
$101.45
in a doctor’s own office or clinic

93.5% of the $108.55 national baseline

Medicare payment
$81.16
Patient / secondary
$20.29
Expected total to provider
$101.45

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Locality-adjusted Physician Fee Schedule pricing

How much does Medicare allow for CPT 76536 in Albuquerque, NM? Copy link

The Medicare allowed amount is $101.45 in the office (non-facility) and facility settings, under the Q3 2026 Physician Fee Schedule. That is 6.5% below the national baseline. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied — not necessarily what a specific claim pays.

What Medicare locality is Albuquerque, NM in? Copy link

CMS prices all of New Mexico as one Medicare payment locality, so this amount applies statewide, including Las Cruces, Rio Rancho and Santa Fe — not only in Albuquerque, NM.

Why Albuquerque, NM differs from the national amount Copy link

Albuquerque, NM (this locality)
$101.45
National PFS baseline (GPCI 1.000)
$108.55

The national figure is a baseline, not an amount any provider is paid. This locality's geographic practice cost indices scale each RVU component before the conversion factor is applied, which puts Albuquerque, NM at 6.5% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.917
Malpractice GPCI
1.201
2026 conversion factor
$33.4009

Formula and inputs Copy link

The office (non-facility) amount for 76536 in Albuquerque, NM: each component's RVU times its GPCI, summed, then multiplied by the conversion factor.

RVU and GPCI components of the Albuquerque, NM allowed amount for 76536
Component RVU × GPCI = Adjusted RVU
Work 0.55 1.000 0.5500
Practice expense 2.66 0.917 2.4392
Malpractice 0.04 1.201 0.0480
Sum of adjusted RVUs 3.0373
× $33.4009 2026 conversion factor $101.45

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Albuquerque, NM. The allowed amount is not the program payment — the rows below separate them. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 76536 in Albuquerque, NM
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $101.45
Non-participating allowed amount 95% of the participating amount. $96.38
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $110.84
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $81.16
Beneficiary coinsurance The remaining 20%. $20.29
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $1.62
Medicare pays after sequestration Program payment net of the sequestration reduction. $79.54

Contracted rate: % of Medicare in Albuquerque, NM Copy link

Commercial contracts are usually written as a percentage of the Medicare fee schedule. Which Medicare amount they mean is the part that gets misread: a contract benchmarked to the fee schedule prices off this locality's allowed amount — $101.45 in the office (non-facility) setting — not the $108.55 national baseline.

Opens the calculator already set to Albuquerque, NM and the office (non-facility) setting. It also compares what a payer actually paid against the expected amount. See how to find your contract's actual percentage.

ZIP codes this Albuquerque, NM rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 439 ZIP codes to this payment locality. 76536 prices identically in every one of them. 1 of them span more than one locality and need ZIP+4 for an exact match.

87001 87002 87004 87005 87006 87007 87008 87009 87010 87011 87012 87013 87014 87015 87016 87017 87018 87020 87021 87022 87023 87024 87025 87026 87027 87028 87029 87031 87032 87034 87035 87036 87037 87038 87040 87041 87042 87043 87044 87045 87046 87047 87048 87049 87051 87052 87053 87056 87057 87059 87060 87061 87062 87063 87064 87068 87070 87072 87083 87101 87102 87103 87104 87105 87106 87107 87108 87109 87110 87111 87112 87113 87114 87115 87116 87117 87118 87119 87120 87121 87122 87123 87124 87125 87131 87140 87144 87151 87153 87154 87158 87165 87174 87176 87180 87181 87184 87185 87187 87190

339 more ZIP codes map to this locality. The Albuquerque, NM locality page lists the full set.

Resolves the ZIP to its payment locality, so you can confirm whether this amount applies.

76536 in nearby payment localities Copy link

Payment localities in the same region as Albuquerque, NM, nearest first. Each amount is that locality's own GPCI-adjusted office (non-facility) figure for 76536. Proximity doesn't imply similar pricing — neighbouring localities often differ.

76536 allowed amount in payment localities near Albuquerque, NM
Metro Allowed amount vs. Albuquerque, NM
Phoenix, AZ $105.61 +4.1%
Denver, CO $114.17 +12.5%
Oklahoma City, OK $98.75 -2.7%
Salt Lake City, UT $103.09 +1.6%
Wichita, KS $99.36 -2.1%
San Antonio, TX $103.89 +2.4%

Every payment locality nationwide is on the CPT 76536 rate map.

Other codes priced in Albuquerque, NM Copy link

Office (non-facility) allowed amounts in this same payment locality, Q3 2026.

Other curated codes and their allowed amounts in Albuquerque, NM
Code Service Albuquerque, NM vs. national
76700 Complete Abdominal Ultrasound $107.51 -5.9%
76705 Limited Abdominal Ultrasound $81.01 -6.0%
76856 Ultrasound $98.81 -6.1%
76641 Ultrasound $94.33 -5.9%
76870 Ultrasound $92.55 -6.1%
76817 Ultrasound $87.65 -5.6%
76815 Ultrasound $76.95 -5.6%
76801 Ultrasound $110.46 -5.5%
76805 Ultrasound $128.01 -5.8%
76816 Ultrasound $104.77 -5.8%
76811 Ultrasound $173.10 -4.9%
99213 Routine Follow-Up Office Visit $91.75 -3.6%

Common questions Copy link

Which ZIP codes does the Albuquerque, NM rate for 76536 cover?
The CMS ZIP-to-locality crosswalk maps 439 ZIP codes to this payment locality, and every one of them prices 76536 identically. Examples include 87001, 87002, 87004, 87005, 87006, 87007. 1 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the 76536 rate in Albuquerque, NM different from the national amount?
The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices — work 1.000, practice expense 0.917, malpractice 1.201 — scale each RVU component before the conversion factor is applied, which is why Albuquerque, NM allows less than the $108.55 baseline.
Does this 76536 rate apply everywhere in New Mexico?
Yes. CMS prices New Mexico as a single Medicare payment locality, so the same GPCIs — and the same allowed amount — apply statewide, not only in Albuquerque, NM. That includes Las Cruces, Rio Rancho and Santa Fe. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.
What is the non-participating amount and limiting charge for 76536 in Albuquerque, NM?
A non-participating provider is paid $96.38 — 95% of the $101.45 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $110.84, which is 115% of the non-participating amount.
How much of the Albuquerque, NM 76536 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($81.16) once the annual Part B deductible is met, and the beneficiary owes 20% ($20.29). Sequestration reduces Medicare's share by about 2% ($1.62), leaving $79.54. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release : this code's RVUs from the relative value file, multiplied by payment locality 04212-05's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release . Releases are immutable: an amount retrieved for a past quarter always reflects that PFS release. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 8,670)
Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 77)
ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Working a claim with an earlier date of service? The calculator prices 76536 in Albuquerque, NM against the release that governed that date. Past releases need a free account; today's rate does not.

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