In 2024, Medicaid providers in Hartford reported $715,097 in claims for services grouped under the Surgery category, as detailed by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 21.6% rise over 2023, when providers billed $587,988 for comparable Surgery services.
Medicaid, a public insurance program funded through a federal-state partnership, provides coverage for low-income people and families, seniors, children and those with disabilities, making it a significant element of the U.S. health care system.
Because Medicaid is funded by taxpayers, local shifts in billing reflect how public health dollars are distributed in that area.
The “Surgery” category consists of a designated set of Medicaid-billed services grouped by care type, using standardized HCPCS and CPT code criteria. Each billing code in this analysis was matched to one service category based on code prefixes and ranges, keeping similar services together and preventing duplicates, ensuring accurate annual rankings.
While spending increased across multiple categories, Surgery was third highest by total Medicaid payments in Hartford for 2024.
On a statewide basis, Surgery ranked ninth by Medicaid payments in Kentucky for 2024.
From 2019 to 2024, Hartford’s Medicaid spending linked to Surgery services grew by $597,385, an increase of 507.5%. The highest acceleration happened in some years, especially in 2023 and 2021.
Though Surgery-related spending was distributed citywide, the large majority was in select ZIP codes. For 2024, ZIP code 42347 saw $715,096 in Medicaid Surgery payments, making up 100% of the category’s payments in Hartford for the year.
Spending within the Surgery category was also highly concentrated among a small number of billing codes.
Surgery payments in Hartford rose 21.6% between 2024 and 2023. Across all Medicaid claims in Hartford, the increase was 15.7% during that period.
The Centers for Medicare & Medicaid Services reports that total federal and state Medicaid spending reached approximately $871.7 billion for fiscal 2023, about 18% of the country’s total health expenditures, growing significantly from $613.5 billion in 2019 prior to the COVID-19 public health emergency.
This rise equals close to 40% growth in a few years, primarily due to higher enrollment and increased care usage during and after the pandemic.
Recent federal budget reforms under the Trump administration put forward sweeping changes to Medicaid funding structures. Legislation such as the “One Big Beautiful Bill Act,” enacted in 2025, is forecasted to cut over $1 trillion in federal Medicaid funding over 10 years. It adds new policies including work requirements and more cost sharing, which could reduce access or coverage for some Medicaid users and gradually limit growth in federal support while shifting more expenses to states as Medicaid continues to cover tens of millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $117,711 | -2.2% |
| 2021 | $173,937 | 47.8% |
| 2022 | $253,329 | 45.6% |
| 2023 | $587,988 | 132.1% |
| 2024 | $715,096 | 21.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,636,584 | 41.7% |
| 2 | Medicine Services and Procedures | $1,024,775 | 16.2% |
| 3 | Surgery | $715,096 | 11.3% |
| 4 | Pathology and Laboratory Procedures | $697,384 | 11% |
| 5 | Radiology Procedures | $693,398 | 11% |
| 6 | Ambulance and Other Transport Services and Supplies | $235,928 | 3.7% |
| 7 | Drugs Administered Other than Oral Method | $195,461 | 3.1% |
| 8 | Outpatient PPS | $56,697 | 0.9% |
| 9 | Procedures / Professional Services | $41,309 | 0.7% |
| 10 | Durable Medical Equipment | $20,159 | 0.3% |
| 11 | Medical And Surgical Supplies | $6,817 | 0.1% |
| 12 | Alcohol and Drug Abuse Treatment | $1,082 | <0.1% |
| 13 | Temporary National Codes (Non-Medicare) | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 69436 | Create eardrum opening | $257,168 | 9 |
| 42820 | Remove tonsils and adenoids | $218,631 | 11 |
| 43239 | Egd biopsy single/multiple | $132,628 | 11 |
| 36415 | Coll venous bld venipuncture | $52,154 | 11 |
| 20610 | Drain/inj joint/bursa w/o us | $44,940 | 13 |
| 45378 | Diagnostic colonoscopy | $7,842 | 1 |
| 45380 | Colonoscopy and biopsy | $1,731 | 1 |
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.
