Orofino Medicaid payments for surgery services climb to $17 in 2024

In 2024, Medicaid providers in Orofino billed $17 for services listed under the Surgery category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount represents a 240% rise from the $5 billed in 2023 for the same category of services.

Medicaid operates as a public health insurance program administered by states and jointly funded by federal and state governments. It serves low-income people, seniors, children and individuals with disabilities, making it a core component of the U.S. health care system.

Since taxpayer funds support Medicaid payments, shifts in billing levels locally can reflect how public health care resources are distributed within communities.

The “Surgery” category includes a variety of Medicaid services grouped by type of care using standardized HCPCS and CPT code definitions. For analytical purposes, each billing code was matched to one service category through consistent code prefixes and numerical ranges, allowing related procedures to be grouped accurately, avoiding double counting, and preserving reliable rankings over time.

While Medicaid outlays rose in several service groups, Surgery placed seventh for total Medicaid payments in Orofino in 2024.

Statewide in Idaho, the Surgery category ranked 13th by total Medicaid payments for 2024.

Over the five years ending in 2024, Orofino saw Medicaid spending on the Surgery category rise by $1,748, an increase of 99%. Spending growth was especially pronounced in some periods, with marked year-over-year growth noted in 2023 and 2022.

Although Surgery category spending was distributed throughout the city, a small number of ZIP codes saw the largest payments. In 2024, ZIP code 83544 accounted for the full $17 billed to Medicaid for Surgery services. Altogether, the top ZIP code represented 100.3% of all Medicaid payments for Surgery in Orofino during 2024.

Medicaid reimbursements within the Surgery category were also focused on a handful of specific billing codes.

To compare, Surgery-related Medicaid payments in Orofino increased 240% from 2023 to 2024, contrasting with a 33.9% overall rise across all Medicaid service categories in the city in that period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending totaled about $871.7 billion in fiscal 2023, making up nearly 18% of the nation’s health spending. That is up sharply from $613.5 billion in 2019, before the onset of COVID-19.

This significant increase—about 40% over a few years—stems mainly from expanded enrollment and higher service use during and after the pandemic.

Federal budget measures enacted during the Trump administration included major proposals for reducing federal Medicaid funding and changing the program’s structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is estimated to cut more than $1 trillion from federal Medicaid spending over the next decade. The legislation introduces policies such as work requirements and higher cost-sharing, which are expected to impact coverage and funding for certain recipients. These shifts are projected to transfer greater financial responsibility to states and limit federal Medicaid growth, despite Medicaid continuing to serve tens of 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.