#2773 of 11K

OP379

HCPCS Procedure Code

HCPCS code OP379 is the #2,773 most-billed Medicaid procedure code, with $3.7M in payments across 61K claims from 2018–2024. The national median cost per claim is $44.23. Costs vary widely — the 90th percentile is $108.01 per claim, 2.4× the median.

Total Paid

$3.7M

0.00% of all spending

Total Claims

61K

Providers

Avg Cost/Claim

$61

National Cost Distribution

How much do providers bill per claim for OP379? Based on 21 providers billing this code nationally.

Median

$44.23

Average

$60.10

Std Dev

$36.27

Max

$147.22

Percentile Distribution (Cost per Claim)

p10

$22.65

p25

$35.82

Median

$44.23

p75

$85.17

p90

$108.01

p95

$108.59

p99

$139.50

50% of providers bill between $35.82 and $85.17 per claim for this code.

90% bill between $22.65 and $108.01.

Top 1% bill above $139.50.

About This Procedure

HCPCS code OP379 was billed by 21 providers across 61K claims, totaling $3.7M in Medicaid payments from 2018–2024. This code was used for 57K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$44.23

Providers Billing

National Spending

$3.7M

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for OP379

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital	$1.0M	$41.14	0.9× median	Below Median
2	1710491253	$967K	$147.22	3.3× median	Top 1%
3	Capital Health System, Inc. Pennington, NJ · General Acute Care Hospital	$689K	$55.50	1.3× median	Above Median
4	1275583726	$229K	$96.91	2.2× median	Above 75th
5	1861486870	$192K	$85.17	1.9× median	Above 75th
6	1295718450	$147K	$78.59	1.8× median	Above Median
7	Hmh Hospitals Corporation Neptune, NJ · General Acute Care Hospital	$116K	$37.50	0.8× median	Below Median
8	Atlanticare Regional Medical Center Pomona, NJ · General Acute Care Hospital	$90K	$44.23	1.0× median	Below Median
9	Jersey City Medical Center Jersey City, NJ · General Acute Care Hospital	$50K	$108.59	2.5× median	Top 10%
10	1477065126	$44K	$105.96	2.4× median	Above 75th
11	1659387975	$43K	$41.45	0.9× median	Below Median
12	1336147834	$24K	$108.01	2.4× median	Top 10%
13	1710499462	$23K	$53.68	1.2× median	Above Median
14	1346247368	$21K	$13.93	0.3× median	Below Median
15	1760994412	$13K	$40.31	0.9× median	Below Median
16	1013386143	$12K	$35.82	0.8× median	Below Median
17	1962409987	$10K	$67.19	1.5× median	Above Median
18	1831601590	$8K	$28.19	0.6× median	Below Median
19	1467440743	$7K	$22.65	0.5× median	Below Median
20	1831197508	$4K	$19.16	0.4× median	Below Median

Showing top 20 of 21 providers billing this code

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