Saratoga Springs Medicaid providers billed $411,825 for Surgery services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 5% increase from 2023, when claims for Surgery totaled $392,327.
Medicaid, a program run by states with funding from both federal and state governments, supports low-income people, seniors, children, and individuals with disabilities, making it a central component of the national health care system.
Fluctuations in Medicaid billing mirror how taxpayer dollars for public health care are deployed at the local level.
The “Surgery” category groups Medicaid services by care type, using consistent HCPCS and CPT code groupings. For this report, each billing code falls under a single service category based on assigned prefixes and numeric ranges, ensuring services are grouped accurately and duplication is avoided as rankings are compared over time.
Surgery placed seventh among Medicaid payment categories in Saratoga Springs in 2024 as overall Medicaid spending climbed across several categories.
On a statewide basis, Surgery was the tenth leading category by Medicaid payments in New York during 2024.
From 2019 through 2024, Medicaid payments for Surgery in Saratoga Springs climbed $171,578, or 71.4%. Several periods brought higher annual increases, notably in 2020 and 2023.
Surgery category payment totals showed the majority of funds concentrated within a small group of ZIP codes. In 2024, ZIP code 12866 posted $411,824 in Medicaid Surgery payments. The top ZIP code accounted for the entire total in Saratoga Springs for the year.
Within the Surgery group, Medicaid payments predominantly went to a small subset of procedure codes.
Medicaid Surgery payments in Saratoga Springs increased 5% between 2023 and 2024, compared with a citywide 29.8% gain across all Medicaid claim categories during the same period.
Centers for Medicare & Medicaid Services data show combined federal and state Medicaid expenditures reached around $871.7 billion in fiscal year 2023—about 18% of total health spending nationwide—rising steadily from $613.5 billion in 2019, before the pandemic.
This marks almost 40% growth in a few years, driven mostly by expanded Medicaid enrollment and increased use of services during and after COVID-19.
Recent federal budget acts under the Trump administration brought proposals to decrease federal Medicaid dollars and to change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is set to reduce federal Medicaid spending by more than $1 trillion over 10 years, introducing measures such as work requirements and higher cost-sharing, potentially affecting coverage and shifting more costs to states even as millions rely on Medicaid for care.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $240,246 | 201.1% |
| 2021 | $259,900 | 8.2% |
| 2022 | $244,800 | -5.8% |
| 2023 | $392,327 | 60.3% |
| 2024 | $411,824 | 5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $3,569,394 | 31.1% |
| 2 | Evaluation and Management | $2,603,650 | 22.7% |
| 3 | Procedures / Professional Services | $1,812,137 | 15.8% |
| 4 | Radiology Procedures | $1,348,810 | 11.7% |
| 5 | Alcohol and Drug Abuse Treatment | $804,743 | 7% |
| 6 | Pathology and Laboratory Procedures | $416,435 | 3.6% |
| 7 | Surgery | $411,824 | 3.6% |
| 8 | Ambulance and Other Transport Services and Supplies | $269,619 | 2.3% |
| 9 | Vision Services | $189,967 | 1.7% |
| 10 | Drugs Administered Other than Oral Method | $37,347 | 0.3% |
| 11 | Dental Services | $18,648 | 0.2% |
| 12 | Administrative, Miscellaneous and Investigational | $6,130 | 0.1% |
| 13 | Temporary Codes | $2,509 | <0.1% |
| 14 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 41899 | Unlisted px dentalvlr strux | $106,744 | 3 |
| 59025 | Fetal non-stress test | $75,936 | 10 |
| 43239 | Egd biopsy single/multiple | $69,772 | 9 |
| 36415 | Coll venous bld venipuncture | $39,062 | 15 |
| 45380 | Colonoscopy and biopsy | $25,974 | 3 |
| 51798 | Us urine capacity measure | $23,698 | 5 |
| 12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | $23,129 | 4 |
| 69436 | Create eardrum opening | $17,435 | 1 |
| 36416 | Collj capillary blood spec | $16,757 | 10 |
| 58300 | Insert intrauterine device | $5,733 | 4 |
| 64615 | Chemodenerv musc migraine | $4,584 | 1 |
| 11721 | Debride nail 6 or more | $1,281 | 1 |
| 20553 | Njx 1/mlt trigger points 3/> | $868 | 1 |
| 20610 | Drain/inj joint/bursa w/o us | $843 | 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.
