OP258
HCPCS Procedure Code
HCPCS code OP258 is the #2,558 most-billed Medicaid procedure code, with $5.0M in payments across 1.5M claims from 2018–2024. The national median cost per claim is $1.95. Costs vary widely — the 90th percentile is $8.26 per claim, 4.2× the median.
Total Paid
$5.0M
0.00% of all spending
Total Claims
1.5M
Providers
67
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for OP258? Based on 67 providers billing this code nationally.
Median
$1.95
Average
$4.87
Std Dev
$11.63
Max
$93.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.97 and $5.60 per claim for this code.
90% bill between $0.66 and $8.26.
Top 1% bill above $47.28.
About This Procedure
HCPCS code OP258 was billed by 67 providers across 1.5M claims, totaling $5.0M in Medicaid payments from 2018–2024. This code was used for 1.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.95
Providers Billing
67
National Spending
$5.0M
Avg/Median Ratio
2.50×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for OP258
| # | Provider | Total Paid |
|---|---|---|
| 1 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $669K |
| 2 | Clara Maass Medical Center Belleville, NJ · General Acute Care Hospital | $475K |
| 3 | Virtua - West Jersey Health System Inc. Voorhees, NJ · General Acute Care Hospital | $375K |
| 4 | Jersey City Medical Center Jersey City, NJ · General Acute Care Hospital | $343K |
| 5 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $324K |
| 6 | Cooperman Barnabas Medical Center Inc Livingston, NJ · General Acute Care Hospital | $310K |
| 7 | Capital Health System, Inc. Pennington, NJ · General Acute Care Hospital | $231K |
| 8 | 1134125016 | $200K |
| 9 | 1609983790 | $173K |
| 10 | 1659387975 | $167K |
| 11 | Kennedy University Hospital Inc. Stratford, NJ · General Acute Care Hospital | $138K |
| 12 | 1235134024 | $136K |
| 13 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $117K |
| 14 | 1013010917 | $106K |
| 15 | 1053316844 | $97K |
| 16 | 1225133473 | $83K |
| 17 | Ahs Hospital Corp. Morristown, NJ · General Acute Care Hospital | $80K |
| 18 | 1861486870 | $75K |
| 19 | Ahs Hospital Corp. Summit, NJ · General Acute Care Hospital | $72K |
| 20 | 1003236878 | $67K |
Showing top 20 of 67 providers billing this code