Pendleton Medicaid billing for surgery services reaches $509,223 in 2024, up 24.6%

Pendleton Medicaid providers reported $509,223 in billing for Surgery category services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This was a 24.6% jump compared to 2023, when billing totaled $408,709 for the same group of services.

Medicaid, a public health insurance initiative administered by states and funded jointly by federal and state governments, insures low-income families and individuals, children, older adults and people with disabilities. It remains one of the largest segments of the U.S. health care system.

Shifts in Medicaid billing locally help illustrate how taxpayer-funded health care dollars are distributed in communities.

The “Surgery” classification encompasses sets of Medicaid-reimbursed services organized by care type, using standardized HCPCS and CPT code groupings. For this data review, each billing code was placed in a single service category with consistent code prefixes and numeric groupings, allowing related procedures to be tracked together and ensuring clear rankings year over year without duplicate counting.

Though Medicaid spending increased across several categories, Surgery was the sixth-largest service category in Pendleton by total Medicaid billing in 2024.

Statewide across Oregon in 2024, the Surgery category ranked 13th in total Medicaid spending.

From 2019 through 2024, Medicaid payments related to the Surgery group in Pendleton rose by $310,073, an increase of 155.7%. The rate of spending climbed more quickly at certain intervals, with significant year-over-year gains seen in 2023 and 2020.

Surgery category spending was distributed across the city, yet primarily concentrated within a small group of ZIP codes. In 2024, ZIP code 97801 alone accounted for $509,222 in claims—representing 100% of the city’s Medicaid payments for Surgery services that year.

Within the Surgery classification, billing totals were focused on a few specific codes.

Compared to a citywide increase of 16.6% for all Medicaid billing categories between 2024 and 2023, the Surgery group saw a 24.6% rise in Pendleton for the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures hit approximately $871.7 billion in fiscal 2023, making up around 18% of U.S. health spending. This figure was up sharply from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This growth represents about a 40% increase over several years, reflecting expanded Medicaid enrollment and higher service utilization during and after the pandemic.

Federal budget laws signed under the Trump administration have included major proposals to reduce federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” which became law in 2025, is expected to cut more than $1 trillion from federal Medicaid budgets over 10 years by introducing measures such as work requirements and higher cost-sharing, changes that could limit coverage and funding for some Medicaid enrollees. As a result, more costs are anticipated to shift to states, reining in federal Medicaid growth even as the program continues providing coverage to tens of millions.

Note: HCPCS codes appear above for added context. Ranking and totals are determined by standard service groupings, not by individual code figures.

Data in this article originates from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the original dataset here.