Medicaid payments for Elma surgery services reach $166,510 in 2024

In 2024, Elma’s Medicaid providers received $166,510 for surgery services, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The total marks a 10% rise from 2023, when such claims totaled $151,377.

Medicaid is a government health insurance program administered at the state level and jointly funded by federal and state governments. The program covers people with low incomes, the elderly, children, and individuals with disabilities, making it a critical part of the U.S. health care infrastructure. More details are available from the Commonwealth Fund.

Since Medicaid payment dollars come from taxpayers, altering billing levels provides insight into how public health resources are distributed within a jurisdiction.

The “Surgery” service group includes Medicaid-billed care categorized according to procedure type, organized by standardized HCPCS and CPT code sets. This analysis designated each billing code to a single service group using matching prefix and number ranges, ensuring related services are grouped together while preventing double reporting and keeping rankings consistent over time.

While payments were up for several service categories, Surgery ranked seventh by total Medicaid payments in Elma in 2024.

Statewide in Washington, Surgery placed 11th by payment volume for the year.

Over the five-year span ending in 2024, Elma’s Medicaid spending linked to Surgery services jumped by $106,060, an increase of 175.4%. Growth accelerated in select periods, especially in 2022 and 2021, based on year-over-year changes.

Although Surgery-related expenditures occurred across Elma, those dollars were largely concentrated within a few ZIP codes. In 2024, ZIP code 98541 accounted for the entire $166,510 total, making up 100% of Medicaid payments for Surgery in the city.

Within Surgery, a small subset of billing codes made up most Medicaid payments.

To compare, Surgery-related Medicaid payments in Elma grew by 10% from 2023 to 2024, while during the same interval, total Medicaid claim payments citywide rose by 7.9%.

According to the Centers for Medicare & Medicaid Services, joint federal and state spending on Medicaid neared $871.7 billion in fiscal year 2023, comprising approximately 18% of health expenditures nationally—a significant jump from the $613.5 billion reported in 2019, prior to the pandemic.

This difference shows a rise of about 40% over several years, mainly due to higher enrollment and increased use during and following the pandemic.

Recent federal budget measures approved during the Trump administration have included substantial proposals to trim federal Medicaid spending and change the program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is slated to cut federal Medicaid expenses by more than $1 trillion over the next decade and brings in new requirements such as work stipulations and higher out-of-pocket costs that could affect access and funds for certain beneficiaries. These modifications are anticipated to transfer some costs to state governments and curb the rise of federal Medicaid funding, even while the program continues serving millions of Americans.

Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.

Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.