Englewood Medicaid Surgery claims reach $30 in 2024, showing 900% jump from prior year

In 2024, Medicaid providers in Englewood submitted $30 in claims for services under the Surgery category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount marked a 900% increase from 2023, when $3 was billed for the same category of services.

Medicaid, a state-operated public health insurance program jointly funded by federal and state governments, covers low-income residents, seniors, children and individuals with disabilities. It forms a major component of the U.S. health care system. More information on how Medicaid is financed can be found here.

Since Medicaid uses taxpayer funds, variations in local billing help demonstrate how a community directs public health care spending.

The “Surgery” group includes certain Medicaid-billed procedures, as identified by established HCPCS and CPT code ranges. This analysis assigned each billing code to a single service category using consistent codes, ensuring services were grouped properly, double counting was avoided and accurate rankings maintained over time.

While spending increased across multiple categories, Surgery was the fourth largest in Englewood by Medicaid payments during 2024.

On a statewide basis in Tennessee, Surgery ranked tenth for Medicaid payments in 2024.

Analyzing the five years preceding 2024, Englewood’s Medicaid payments related to Surgery rose by $170, an 85% gain. Growth was particularly notable in specific periods, with significant increases between 2022 and 2023.

Surgery-related Medicaid payments were distributed throughout Englewood, but were mainly concentrated in a handful of ZIP codes. The leading ZIP code for Surgery payments in 2024 was 37329, where providers billed $30. Altogether, that ZIP code accounted for 100% of Surgery-related Medicaid payments in Englewood during the year.

In this category, Medicaid payments were highly focused on a select number of billing codes.

To provide context, Surgery-related Medicaid payments in Englewood increased 900% from 2023 to 2024, whereas all claim categories together rose by 96.2% in the city over the same time frame.

Centers for Medicare & Medicaid Services data show combined state and federal Medicaid spending reached an estimated $871.7 billion in fiscal 2023—roughly 18% of national health expenditures—up significantly from $613.5 billion in 2019, prior to COVID-19.

The jump represents around 40% growth in just a few years, mostly attributed to increased Medicaid enrollment and higher usage during and after the pandemic period.

Recent federal budget actions under the Trump administration introduced major proposals to lower federal Medicaid funding and alter the program’s structure. For instance, the “One Big Beautiful Bill Act,” became law in 2025 and is projected to reduce federal Medicaid spending by more than $1 trillion over 10 years. The law includes provisions such as work requirements and greater cost-sharing, likely decreasing coverage and funding for certain groups. These changes are expected to place more responsibility on states and slow federal Medicaid spending growth, even as millions of Americans remain enrolled in the program.

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.