In 2024, Medicaid providers in Sebring submitted $202,880 in claims for services within the Surgery category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. That amount represents a 4.4% rise from 2023, when billing for the same service category reached $194,302.
Medicaid, a state-managed program financed through joint federal and state contributions, provides coverage for low-income residents, including seniors, families, children, and individuals with disabilities. The program serves as a major component of the national health care system.
Given that Medicaid funds originate from taxpayers, fluctuations in local claim levels help indicate how health care expenditures are distributed within communities.
The “Surgery” service category encompasses a selection of Medicaid-billed procedures identified according to the type of care involved, using standardized HCPCS and CPT code ranges and prefixes. To compile this overview, each code was grouped into a single category, ensuring related procedures could be reviewed collectively, avoiding duplicated counts and sustaining consistent ranking from year to year.
Despite broader increases in Medicaid spending among several service areas, Surgery placed seventh in Sebring for total Medicaid payments in 2024.
Statewide in Florida, Surgery was the 13th largest service category by total Medicaid payments for 2024.
Reviewing a five-year period through 2024, local Medicaid payments associated with the Surgery category in Sebring increased by $195,727—a growth rate of 2736.3%. The sharpest annual gains occurred in 2022 and 2023.
Although payments for Surgery-related care were made throughout Sebring, they were concentrated in a small number of ZIP codes. In 2024, the highest payments went to ZIP codes 33872, totaling $130,682, and 33870, with $72,197. Together, those two ZIP codes comprised 100% of total Medicaid Surgery payments in Sebring for the year.
Medicaid expenditures within the Surgery category were focused around a relatively small set of individual billing codes.
Between 2023 and 2024, Medicaid payments for Surgery services in Sebring increased by 4.4%, while the cumulative change across all local Medicaid claim categories was 42.9% during the same span.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures reached approximately $871.7 billion for fiscal year 2023, contributing to about 18% of U.S. national health expenses—up significantly from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
The gap is driven largely by a roughly 40% expansion over several years due to increased program enrollment and service usage during and after the pandemic.
Legislation from the Trump administration included major legislative changes impacting Medicaid’s funding structure. The “One Big Beautiful Bill Act,” enacted in 2025, is set to trim more than $1 trillion from federal Medicaid spending over the next ten years. It adds work requirements and greater cost-sharing, which may reduce access and government support for certain recipients. As a result, greater responsibilities are shifting to state governments for managing program costs, even as Medicaid continues providing health coverage to tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $7,152 | -58.8% |
| 2021 | $5,447 | -23.8% |
| 2022 | $96,210 | 1666.3% |
| 2023 | $194,302 | 102% |
| 2024 | $202,880 | 4.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $4,780,804 | 56.1% |
| 2 | National Codes Established for State Medicaid Agencies | $1,772,096 | 20.8% |
| 3 | Medicine Services and Procedures | $470,393 | 5.5% |
| 4 | Ambulance and Other Transport Services and Supplies | $343,494 | 4% |
| 5 | Radiology Procedures | $287,953 | 3.4% |
| 6 | Alcohol and Drug Abuse Treatment | $203,253 | 2.4% |
| 7 | Surgery | $202,880 | 2.4% |
| 8 | Temporary National Codes (Non-Medicare) | $139,043 | 1.6% |
| 9 | Durable Medical Equipment | $136,907 | 1.6% |
| 10 | Procedures / Professional Services | $95,346 | 1.1% |
| 11 | Pathology and Laboratory Procedures | $81,906 | 1% |
| 12 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $4,520 | 0.1% |
| 13 | Drugs Administered Other than Oral Method | $3,518 | <0.1% |
| 14 | Medical And Surgical Supplies | $3,175 | <0.1% |
| 15 | Dental Services | $2,438 | <0.1% |
| 16 | Vision Services | $951 | <0.1% |
| 17 | Temporary Codes | $66 | <0.1% |
| 18 | Coronavirus Diagnostic Panel | $9 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 59025 | Fetal non-stress test | $157,678 | 73 |
| 59410 | Obstetrical care | $42,090 | 3 |
| 59430 | Care after delivery | $2,887 | 4 |
| 51798 | Us urine capacity measure | $181 | 7 |
| 36415 | Coll venous bld venipuncture | $43 | 12 |
| 36416 | Collj capillary blood spec | $0 | 11 |
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.
