OP250
Orthotic or prosthetic procedure, not otherwise classified
Orthotic or prosthetic procedure, not otherwise classified is the #821 most-billed Medicaid procedure code, with $72.5M in payments across 6.5M claims from 2018–2024. The national median cost per claim is $1.68. Costs vary widely — the 90th percentile is $18.21 per claim, 10.8× the median.
Total Paid
$72.5M
0.01% of all spending
Total Claims
6.5M
Providers
207
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for OP250? Based on 156 providers billing this code nationally.
Median
$1.68
Average
$5.63
Std Dev
$9.89
Max
$52.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.01 and $6.24 per claim for this code.
90% bill between $0.00 and $18.21.
Top 1% bill above $44.31.
About This Procedure
HCPCS code OP250 (Orthotic or prosthetic procedure, not otherwise classified) was billed by 207 providers across 6.5M claims, totaling $72.5M in Medicaid payments from 2018–2024. This code was used for 3.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.68
Providers Billing
156
National Spending
$72.5M
Avg/Median Ratio
3.35×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for OP250
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $16.5M |
| 2 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $10.0M |
| 3 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $7.8M |
| 4 | Jersey City Medical Center Jersey City, NJ · General Acute Care Hospital | $4.8M |
| 5 | Clara Maass Medical Center Belleville, NJ · General Acute Care Hospital | $4.7M |
| 6 | Cooperman Barnabas Medical Center Inc Livingston, NJ · General Acute Care Hospital | $4.0M |
| 7 | 1609983790 | $4.0M |
| 8 | 1043475668 | $2.0M |
| 9 | 1871859306 | $1.6M |
| 10 | Atlanticare Regional Medical Center Pomona, NJ · General Acute Care Hospital | $1.2M |
| 11 | 1013010917 | $1.1M |
| 12 | 1225133473 | $1.0M |
| 13 | Ahs Hospital Corp. Morristown, NJ · General Acute Care Hospital | $990K |
| 14 | St Josephs University Medical Center Inc. Paterson, NJ · General Acute Care Hospital | $966K |
| 15 | 1003236878 | $948K |
| 16 | Ahs Hospital Corp. Summit, NJ · General Acute Care Hospital | $930K |
| 17 | Capital Health System, Inc. Pennington, NJ · General Acute Care Hospital | $753K |
| 18 | 1821101239 | $732K |
| 19 | 1861486870 | $691K |
| 20 | 1659387975 | $675K |
Showing top 20 of 207 providers billing this code