This provider's $72.6M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
85% of their billing comes from a single procedure code (88305 — Pathology examination of tissue using a microscope, intermediate complexity).
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $132.78 | $60.85 | 2.18x | $71.93 | $9.1M | 148.8K | 24 |
| 2015 | $130.49 | $62.19 | 2.10x | $68.30 | $9.4M | 150.9K | 21 |
| 2016 | $131.91 | $63.77 | 2.07x | $68.14 | $9.2M | 143.6K | 24 |
| 2017 | $132.60 | $59.71 | 2.22x | $72.89 | $8.3M | 139.1K | 21 |
| 2018 | $130.52 | $58.97 | 2.21x | $71.55 | $7.8M | 132.1K | 20 |
| 2019 | $132.41 | $59.91 | 2.21x | $72.50 | $6.8M | 113.5K | 17 |
| 2020 | $131.84 | $61.06 | 2.16x | $70.78 | $4.6M | 75.6K | 15 |
| 2021 | $133.09 | $64.86 | 2.05x | $68.23 | $5.4M | 82.7K | 16 |
| 2022 | $133.46 | $63.94 | 2.09x | $69.52 | $5.9M | 92.9K | 16 |
| 2023 | $133.51 | $63.18 | 2.11x | $70.33 | $6.2M | 98.4K | 16 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1.0M | $61.9M | $60.42 | 2.20x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 29.0K | $2.6M | $90.27 | 1.76x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 20.1K | $1.7M | $83.80 | 1.71x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 43.7K | $1.6M | $37.52 | 2.65x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 16.1K | $1.5M | $90.73 | 1.57x |
| 88350 | Antibody evaluation, each additional single antibody stain procedure | 14.5K | $1.2M | $81.75 | 1.61x |
| 88346 | Antibody evaluation, initial single antibody stain procedure | 11.0K | $1.1M | $95.44 | 1.38x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 2.5K | $224.6K | $88.27 | 1.67x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 2.9K | $202.4K | $69.00 | 2.12x |
| 88365 | Genetic sequencing localization, initial procedure | 936 | $143.1K | $152.93 | 1.72x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 2.1K | $138.0K | $64.45 | 1.89x |
| 88321 | Surgical pathology consultation and report on referred slides prepared elsewhere | 1.2K | $108.0K | $88.36 | 1.98x |
| 88364 | Genetic sequencing localization, each additional procedure | 786 | $91.8K | $116.79 | 2.28x |
| 87101 | Fungal culture (mold or yeast) of skin, hair, or nail | 2.8K | $27.9K | $10.10 | 1.98x |
| 81340 | Gene analysis (T cell antigen receptor beta) amplification methodology | 85 | $23.2K | $273.45 | 1.10x |
| 81342 | Gene rearrangement analysis detection abnormal clonal population (T cell antigen receptor gamma) | 78 | $20.7K | $265.94 | 1.50x |
| 87107 | Culture for identification of yeast | 1.4K | $18.3K | $13.54 | 1.48x |
| 88323 | Surgical pathology consultation and report on referred material requiring preparation of slides | 153 | $17.3K | $112.88 | 2.30x |
| 88319 | Evaluation of specimen enzymes | 156 | $12.9K | $82.85 | 2.29x |
| 87220 | Tissue fungi or parasites | 1.6K | $9.2K | $5.67 | 1.76x |
This provider submits charges 2.14 times higher than what Medicare actually pays.
A markup ratio of 2.14x means for every $100 Medicare pays, this provider initially charges $214. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Clinical Laboratory providers in NY for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Northwell Health Laboratories | New Hyde Park, NY | $299.4M | ⚠️ Flagged |
| Sunrise Medical Laboratories, Inc. | Hicksville, NY | $281.2M | ⚠️ Flagged |
| Lenco Diagnostic Laboratories,inc. | Brooklyn, NY | $101.5M | ⚠️ Flagged |
| Enzo Clinical Labs, Inc. | Farmingdale, NY | $100.1M | ⚠️ Flagged |
| Cblpath, Inc | Rye Brook, NY | $94.4M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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