Shinnston sees 17.6% jump in Medicaid Surgery payments for 2024

In 2024, Medicaid providers in Shinnston billed $35,810 for services in the Surgery category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was up 17.6% from 2023, when $30,447 in claims for the same services were submitted.

Medicaid is a state-administered public health insurance program funded by federal and state governments together. It supports low-income families and individuals, seniors, children, and people with disabilities, making it a key component of the U.S. health care system.

Since Medicaid relies on taxpayer funding, shifts in local billing levels reveal how public health resources are distributed within a community.

The “Surgery” category includes Medicaid-billed services organized by care type using standard HCPCS and CPT code groups. This analysis sorted each billing code into a single service group based on consistent code prefixes and numeric ranges, allowing services to be grouped together, preventing double counting, and maintaining accuracy in ranking over time.

While Medicaid spending saw growth in several service groups, Surgery was the fourth-highest by payment volume among Medicaid categories in Shinnston in 2024.

Across West Virginia, Surgery ranked as the 11th most paid Medicaid service category by total payments for 2024.

Between the five years preceding 2024, Medicaid payments in the Surgery category in Shinnston rose by $28,566, an increase of 394.3%. Accelerated growth occurred in specific years, with significant annual jumps noted in both 2022 and 2023.

Although Surgery billings came from different parts of the city, most payments were limited to a small number of ZIP codes. The ZIP code with the highest amount in 2024 was 26431, totaling $35,810, accounting for 100% of all Medicaid Surgery payments in the city for the year.

Surgery-related Medicaid payments in Shinnston focused mainly on a small set of specific billing codes.

During 2024, Medicaid payments for the Surgery category in Shinnston increased by 17.6% year over year. This compared with a rate of 13% for all Medicaid categories citywide during the same period.

Centers for Medicare & Medicaid Services data show federal and state Medicaid spending together totaled around $871.7 billion in fiscal 2023. That represented about 18% of total U.S. health expenditures, rising sharply from almost $613.5 billion in 2019, before the onset of COVID-19.

This increase, nearly 40% higher in a few years, is largely attributed to expanded program enrollment and greater utilization observed during and after the pandemic.

Recent Trump administration federal budgets have introduced major proposals to curtail federal Medicaid funding and modify the program’s structure. One such example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to slash federal Medicaid funding by more than $1 trillion over the next decade and includes new elements like work requirements and higher cost-sharing, potentially reducing coverage or funding for some participants. These changes could cause states to take on more costs, constraining federal growth for Medicaid even as the program remains a cornerstone for 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.