Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1968 of 11K

OP270

HCPCS Procedure Code

HCPCS code OP270 is the #1,968 most-billed Medicaid procedure code, with $10.8M in payments across 504K claims from 2018–2024. The national median cost per claim is $7.34. Costs vary widely — the 90th percentile is $49.72 per claim, 6.8× the median.

Total Paid

$10.8M

0.00% of all spending

Total Claims

504K

Providers

73

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for OP270? Based on 69 providers billing this code nationally.

Median

$7.34

Average

$17.57

Std Dev

$27.50

Max

$183.57

Percentile Distribution (Cost per Claim)

p10
$1.70
p25
$3.74
Median
$7.34
p75
$24.08
p90
$49.72
p95
$57.58
p99
$122.58

50% of providers bill between $3.74 and $24.08 per claim for this code.

90% bill between $1.70 and $49.72.

Top 1% bill above $122.58.

About This Procedure

HCPCS code OP270 was billed by 73 providers across 504K claims, totaling $10.8M in Medicaid payments from 2018–2024. This code was used for 422K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.34

Providers Billing

69

National Spending

$10.8M

Avg/Median Ratio

2.39×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for OP270

#ProviderTotal Paid
1University Hospital

Newark, NJ · General Acute Care Hospital

$2.4M
2Ahs Hospital Corp.

Morristown, NJ · General Acute Care Hospital

$1.5M
3Kennedy University Hospital Inc.

Stratford, NJ · General Acute Care Hospital

$1.2M
4Robert Wood Johnson University Hospital, Inc

New Brunswick, NJ · General Acute Care Hospital

$1.0M
5Ahs Hospital Corp.

Summit, NJ · General Acute Care Hospital

$974K
61811994809$565K
71922095116$379K
8Trinitas Regional Medical Center

Elizabeth, NJ · General Acute Care Hospital

$349K
91770901761$332K
10Saint Peter's University Hospital

New Brunswick, NJ · General Acute Care Hospital

$228K
11Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$210K
121861486870$201K
13Cooperman Barnabas Medical Center Inc

Livingston, NJ · General Acute Care Hospital

$160K
141295718450$150K
15Atlanticare Regional Medical Center

Pomona, NJ · General Acute Care Hospital

$115K
161013386143$93K
171568825545$78K
181366097032$63K
191790789212$60K
201730692344$55K

Showing top 20 of 73 providers billing this code