Medicaid radiology procedure payments in Los Angeles reach $78 million in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
0Comments

In 2024, Los Angeles Medicaid providers charged $78,051,848 for Radiology Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That total reflects a 0.4% rise from 2023, when claims for these services reached $77,739,727.

Medicaid, a public health insurance program run by states with both federal and state funding, offers coverage to low-income individuals, families, seniors, children, and people with disabilities, making it one of the largest U.S. health care programs. More information can be found at this link.

Since Medicaid uses taxpayer dollars, fluctuations in local billing highlight shifts in how community health care resources are distributed.

The “Radiology Procedures” category encompasses a group of Medicaid-billed services based on the nature of provided care, categorized by standardized HCPCS and CPT codes. For this analysis, billing codes were consistently assigned to a single service category, grouping related procedures and avoiding duplicate counts for accurate tracking and ranking over time.

Radiology Procedures was the seventh-largest Medicaid service category in terms of total payments in Los Angeles for 2024, as increases in spending appeared in several categories.

On a statewide basis, the Radiology Procedures category held the 10th spot for total Medicaid payments in California during 2024.

Between 2019 and 2024, Medicaid payments in Los Angeles for Radiology Procedures rose by $15,113,840, a 24% increase. The rate of growth was higher in certain years, with 2021 and 2022 showing significant annual increases.

Citywide, spending on Radiology Procedures was distributed throughout Los Angeles, but most payments were concentrated in a few ZIP codes. The largest Medicaid payments for Radiology Procedures in 2024 occurred in ZIP code 90025 ($37,281,987), 90027 ($11,548,256), and 90033 ($8,425,371). Combined, these top 3 ZIP codes represented 73.4% of all citywide payments for Radiology Procedures during the year.

Medicaid expenditures for Radiology Procedures were also focused on a small number of individual billing codes within the category.

Compared with the 0.4% year-over-year growth for Radiology Procedures payments in Los Angeles between 2024 and 2023, all Medicaid claim categories in the city combined saw a 12.9% change in the same timeframe.

According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, or about 18% of national health expenditures, up substantially from $613.5 billion in 2019 before the COVID-19 pandemic.

This marks an almost 40% increase over a few years, driven mainly by expanded enrollment and increased use during and after the pandemic period.

Recently enacted federal budget laws, including those passed under the Trump administration, contain major proposals for reducing federal Medicaid funding and adjusting how the program operates. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid outlays by more than $1 trillion in the coming decade, and includes measures such as new work requirements and increased cost-sharing, both of which could limit coverage and funding for some beneficiaries. These changes are likely to move more cost responsibility to states and slow the growth of federal Medicaid assistance, even as the program continues to serve tens of millions across the country.

Medicaid Payments Tied to Radiology Procedures in Los Angeles, California Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $62,938,008 -1.2%
2021 $69,931,898 11.1%
2022 $76,958,164 10%
2023 $77,739,726 1%
2024 $78,051,848 0.4%
Top Categories by Medicaid Payments in Los Angeles, California, 2024

Rank Category Medicaid Payments Share of City Total
1 National Codes Established for State Medicaid Agencies $569,995,717 26.5%
2 Medicine Services and Procedures $398,580,366 18.5%
3 Alcohol and Drug Abuse Treatment $359,235,604 16.7%
4 Evaluation and Management $269,652,307 12.5%
5 Temporary National Codes (Non-Medicare) $140,525,379 6.5%
6 Procedures / Professional Services $85,635,112 4%
7 Radiology Procedures $78,051,848 3.6%
8 Pathology and Laboratory Procedures $73,729,299 3.4%
9 Anesthesia $56,555,584 2.6%
10 Dental Services $38,190,827 1.8%
11 Ambulance and Other Transport Services and Supplies $19,073,838 0.9%
12 Surgery $16,031,718 0.7%
13 Drugs Administered Other than Oral Method $10,971,030 0.5%
14 Temporary Codes $10,901,505 0.5%
15 Medical And Surgical Supplies $6,626,671 0.3%
16 Chemotherapy Drugs $4,580,181 0.2%
17 Durable Medical Equipment $4,518,507 0.2%
18 Vision Services $1,246,414 0.1%
19 Hearing Services $1,235,353 0.1%
20 Administrative, Miscellaneous and Investigational $913,883 <0.1%
21 Enteral and Parenteral Therapy $881,282 <0.1%
22 Outpatient PPS $520,140 <0.1%
23 Pathology and Laboratory Services $333,333 <0.1%
24 Coronavirus Diagnostic Panel $286,451 <0.1%
25 Orthotic Procedures and services $258,444 <0.1%
26 Durable medical equipment (DME) Medicare administrative contractors (MACs) $246,641 <0.1%
27 Prosthetic Procedures $103,990 <0.1%
28 Diagnostic Radiology Services $17,411 <0.1%
29 Other Services $0 <0.1%
Top 20 HCPCS Codes Within the Radiology Procedures Category in Los Angeles, California, 2024

HCPCS Code Description Medicaid Payments Claims
77067 Scr mammo bi incl cad $5,650,075 1,124
74177 Ct abd & pelvis w/contrast $5,503,874 755
78815 Pet image w/ct skull-thigh $4,872,289 196
70553 Mri brain stem w/o & w/dye $3,952,168 478
70450 Ct head/brain w/o dye $3,332,115 1,100
72148 Mri lumbar spine w/o dye $2,979,831 488
70551 Mri brain stem w/o dye $2,665,786 535
73721 Mri jnt of lwr extre w/o dye $2,458,825 359
77386 $2,399,287 99
74176 Ct abd & pelvis w/o contrast $2,273,966 490
77063 Breast tomosynthesis bi $2,001,088 622
76700 Us exam abdom complete $1,647,874 879
71046 X-ray exam chest 2 views $1,611,070 1,507
71045 X-ray exam chest 1 view $1,603,434 2,322
76856 Us exam pelvic complete $1,508,751 764
72141 Mri neck spine w/o dye $1,506,793 313
74178 Ct abd&plv wo cntr flwd cntr $1,498,096 198
76830 Transvaginal us non-ob $1,345,905 651
73221 Mri joint upr extrem w/o dye $1,285,589 213
71250 Ct thorax dx c- $1,247,006 402

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.



Related

Buzz Patterson

Los Angeles-based author Buzz Patterson: 340b drug discount program is ‘an $80 billion scam’

Los Angeles-based author Buzz Patterson called the federal 340B drug pricing program an ‘$80 billion scam’ in a post on X, arguing it has become one of the ‘least accountable’ corners of American healthcare.

Mayor Karen Bass

Los Angeles to host free World Cup watch parties across city parks in June

Free World Cup watch parties will be held across Los Angeles parks beginning June 12. The events are part of a partnership involving local officials aiming for inclusive access throughout diverse neighborhoods. City leaders highlight their commitment to equity through public engagement.

Dr. Mehmet Oz CMS Administrator

Los Angeles Medicaid dental payments reach $38.2M in 2024, rising 3% from previous year

In 2024, Los Angeles Medicaid providers reported $38,190,827 in payments for Dental Services, marking a 3% increase from the prior year.

Trending

The Weekly Newsletter

Sign-up for the Weekly Newsletter from LAX Leader.