I believe the “factory PTO” is just a SAE standard 6 bolt PTO outlet on the automatic transmission. Almost all recent self respecting manuals (NV4500 & 5600, ZFs, Getrags) seen in recent full sized pickups had such, I believe Allisons even the little 1000 have them.
Once you have the PTO outlet you can then buy something like a Chelsea PTO box, which can run either a PTO winch; ormuch more useful a combined PTO/hydraulic pump. What’s that good for?
I have an admittedly boutique camper: a 4.8m (15’ 9”) Unicat on a very civilized Mercedes U500 Unimog, purchased new when they were selling them in North America in 2005. I ordered the simplest hydraulic system for the front and rear winches. A 20k DP in the front and 15k Superwinch in the rear. Just used rear winch last Thursday to pull a stuck 2wd big International dump/boom truck delivering free big logs for firewood into my slightly snowy front yard.
What else is hydraulics good for? A lot, actually.
I purchased a Harrison Hydragen US made (!!!) 3.6kw 240/120v generator that can run my entire house for an amazing $1300 last year.
In February I got a Boss 22 ton hydraulic wood splitter designed for farm tractors, mounted on I beam skids. I happen to heat my house mainly with wood. I have split 6 cords so far, another 11-12 to go.
You can run an innumerable variety of outdoor tools with hydraulics.
But I think the $280 just buys you the PTO outlet on the transmission and the driving gear inside the automatic transmission. Me being me, getting it would be a no-brainer.