Surgery-related Medicaid payments in Pismo Beach reach $444,119 in 2024, up 38.2%

In 2024, Pismo Beach Medicaid providers billed $444,119 for services categorized as Surgery, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database indicate. This represented a 38.2% rise from 2023, when claims for these services totaled $321,353.

Medicaid is a publicly funded health insurance program operated by states and financed in partnership between federal and state governments. It provides coverage for low-income individuals and families, seniors, children, and people with disabilities—one of the country’s largest health care programs.

Because funding for Medicaid comes from taxpayer dollars, shifts in local billing levels reveal how community health care spending is directed.

The “Surgery” classification encompasses services based on care type using standardized HCPCS and CPT billing codes. Codes were consistently assigned to one category for this analysis, utilizing consistent prefixes and number ranges to ensure grouped comparison while preventing overlap and maintaining reliable yearly rankings.

While overall Medicaid payments grew in several service areas, Surgery placed second by total Medicaid billing in Pismo Beach in 2024.

Statewide in California, Surgery held the 12th spot among Medicaid payment categories in 2024.

During the five years preceding 2024, Pismo Beach’s Surgery-related Medicaid payments grew by $441,406, or 16272%. The most significant year-over-year jumps occurred in 2022 and 2023 as the pace of spending growth increased during certain intervals.

Although Surgery-related Medicaid billing was recorded throughout Pismo Beach, most payments were concentrated within a few ZIP codes. In 2024, ZIP code 93449 accounted for the full $444,119 in Surgery-related Medicaid payments. Altogether, the top single ZIP code made up 100% of Pismo Beach’s Surgery-category Medicaid payments for the year.

Within the Surgery classification, most Medicaid payments were tied to a small selection of specific billing codes.

From 2023 to 2024, Medicaid spending in the Surgery category in Pismo Beach climbed by 38.2%, compared to a 9.5% change for all Medicaid claim categories citywide.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion during fiscal year 2023, or roughly 18% of national health expenditures. This marks a substantial increase from around $613.5 billion in 2019 before the COVID-19 pandemic.

This jump reflects growth of about 40% in a few years, due largely to increased enrollment and service use during and following the pandemic.

Budget legislation during the Trump administration brought forward major proposals to scale back federal Medicaid contributions and change the program’s structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is set to reduce federal Medicaid spending by more than $1 trillion over the decade and add measures such as work requirements and expanded cost-sharing, which may reduce coverage and funding for certain beneficiaries. This is expected to shift a greater financial burden to the states and restrict the growth of federal Medicaid funding while the program continues to assist tens of millions of people.

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.