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#1822 of 11K

OP279

HCPCS Procedure Code

HCPCS code OP279 is the #1,822 most-billed Medicaid procedure code, with $13.3M in payments across 216K claims from 2018–2024. The national median cost per claim is $10.76. Costs vary widely — the 90th percentile is $47.61 per claim, 4.4× the median.

Total Paid

$13.3M

0.00% of all spending

Total Claims

216K

Providers

41

Avg Cost/Claim

$62

National Cost Distribution

How much do providers bill per claim for OP279? Based on 41 providers billing this code nationally.

Median

$10.76

Average

$25.04

Std Dev

$43.69

Max

$183.76

Percentile Distribution (Cost per Claim)

p10
$2.60
p25
$6.43
Median
$10.76
p75
$22.61
p90
$47.61
p95
$156.08
p99
$181.90

50% of providers bill between $6.43 and $22.61 per claim for this code.

90% bill between $2.60 and $47.61.

Top 1% bill above $181.90.

About This Procedure

HCPCS code OP279 was billed by 41 providers across 216K claims, totaling $13.3M in Medicaid payments from 2018–2024. This code was used for 189K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.76

Providers Billing

41

National Spending

$13.3M

Avg/Median Ratio

2.33×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for OP279

#ProviderTotal Paid
1University Hospital

Newark, NJ · General Acute Care Hospital

$6.5M
2Englewood Hospital And Medical Center

Englewood, NJ · General Acute Care Hospital

$4.7M
31467440743$434K
4Inspira Medical Centers Inc.

Vineland, NJ · General Acute Care Hospital

$352K
51366097032$301K
61053382697$243K
71710491253$136K
81255396024$65K
91013386143$62K
101629069638$51K
111770901761$45K
121982720249$44K
131861486870$42K
141689682999$41K
151972141091$36K
161184601288$30K
171659387975$29K
181477065126$29K
19Hmh Hospitals Corporation

Neptune, NJ · General Acute Care Hospital

$28K
201831601590$25K

Showing top 20 of 41 providers billing this code