Medicaid Surgery category spending climbs to $1,448 in Carthage for 2024

During 2024, Medicaid providers in Carthage billed $1,448 for services in the Surgery category, based on information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 4.8% gain from the prior year, when claims for the same type of service totaled $1,382.

Medicaid is a state-administered public health insurance program funded both federally and by states. It provides coverage for low-income people and families, seniors, children, and those with disabilities and represents a major segment of the U.S. health care system.

Because Medicaid is taxpayer funded, fluctuations in local billing give insight into how health care spending is distributed in the community.

The “Surgery” category includes Medicaid-billed procedures grouped by the specific type of care, using standardized HCPCS and CPT code groupings. In this analysis, billing codes were assigned to one service category each using consistent prefixes and ranges, making it possible to analyze related services while preventing duplication and ensuring accurate rankings across time.

While Medicaid expenditures climbed in multiple service areas, Surgery ranked eighth among Carthage’s Medicaid payment categories in 2024.

Across Tennessee, Surgery ranked 10th by total Medicaid payments in 2024.

From five years before 2024, Medicaid payments in the Surgery category for Carthage rose by $1,193, an increase of 468.6%. The fastest growth occurred during several periods, with large year-over-year increases in 2021 and 2023.

Although Surgery services were provided citywide, Medicaid payments were largely concentrated within a limited number of ZIP codes. In 2024, ZIP code 37030 accounted for $1,448 of the Surgery category’s Medicaid payments. Collectively, this ZIP code represented 100% of Surgery-related Medicaid payments in Carthage that year.

Within the Surgery group, Medicaid spending was focused mainly on a select set of billing codes.

To put this increase in context: Surgery payments in Carthage were up 4.8% from 2023 to 2024, while all Medicaid claim categories in the city experienced a 36.9% change during that span.

According to the Centers for Medicare & Medicaid Services, combined Medicaid spending by federal and state sources reached about $871.7 billion in fiscal year 2023, which is roughly 18% of total national health expenditures. This figure was up substantially from around $613.5 billion in 2019, before the COVID-19 emergency.

This increase, driven largely by expanded program enrollment and upticks in utilization during and after the pandemic, marks growth of approximately 40% over just a few years.

The Trump administration’s recent federal budget legislation included major provisions to cut federal Medicaid funding and change program structure. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the coming decade. The law introduces new work requirements and higher cost-sharing, which may reduce coverage and federal funding for some participants. These changes are projected to shift more costs to states and curb federal Medicaid growth, while the program continues to cover tens of millions of people in the U.S.

Note: HCPCS codes are included for reference within the category. Totals and rankings in this article are calculated using standardized service groupings, not individual billing codes.

Information for this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original data is available here.