This provider's $160.7M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 621% from 2014 to 2023.
62% of their billing comes from a single procedure code (81518 — Mrna gene analysis of 11 genes in breast tumor tissue).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 92% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $1.5K | $825.44 | 1.76x | $626.73 | $5.3M | 6.5K | 10 |
| 2015 | $2.0K | $1.6K | 1.25x | $390.88 | $8.8M | 5.5K | 7 |
| 2016 | $3.4K | $3.1K | 1.08x | $261.69 | $10.8M | 3.5K | 4 |
| 2017 | $3.2K | $2.9K | 1.09x | $264.86 | $4.7M | 1.6K | 3 |
| 2018 | $6.8K | $3.5K | 1.91x | $3.2K | $8.2M | 2.3K | 2 |
| 2019 | $6.4K | $3.7K | 1.72x | $2.7K | $12.4M | 3.3K | 3 |
| 2020 | $6.2K | $3.7K | 1.65x | $2.4K | $13.6M | 3.6K | 4 |
| 2021 | $5.8K | $3.8K | 1.52x | $2.0K | $26.1M | 6.8K | 4 |
| 2022 | $5.7K | $3.8K | 1.51x | $1.9K | $32.3M | 8.6K | 3 |
| 2023 | $5.6K | $3.8K | 1.50x | $1.9K | $38.4M | 10.2K | 3 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81518 | Mrna gene analysis of 11 genes in breast tumor tissue | 25.9K | $99.0M | $3.8K | 1.42x |
| 81540 | Gene analysis (cancer) | 10.6K | $36.8M | $3.5K | 1.87x |
| 81479 | Molecular pathology procedure | 6.6K | $21.2M | $3.2K | 1.29x |
| 84999 | Chemistry procedures | 842 | $2.4M | $2.9K | 1.75x |
| 88368 | Microscopic genetic analysis of tissue | 2.2K | $397.6K | $179.82 | 1.51x |
| 81235 | Gene analysis (epidermal growth factor receptor), common variants | 778 | $251.2K | $322.92 | 1.55x |
| 81404 | Molecular pathology procedure level 5 | 1.5K | $142.4K | $92.27 | 1.17x |
| 81275 | Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons 12 and 13 | 737 | $134.9K | $183.04 | 1.18x |
| 81210 | Gene analysis (v-raf murine sarcoma viral oncogene homolog B1) | 741 | $126.7K | $171.02 | 1.07x |
| 88381 | Preparation of specimen, manual | 875 | $95.2K | $108.80 | 1.82x |
| 88369 | Microscopic genetic examination manual | 635 | $38.2K | $60.24 | 4.32x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 284 | $15.9K | $56.16 | 3.16x |
| 88380 | Preparation of specimen using laser | 89 | $8.0K | $89.35 | 2.24x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 108 | $7.9K | $72.90 | 2.18x |
This provider submits charges 1.51 times higher than what Medicare actually pays.
A markup ratio of 1.51x means for every $100 Medicare pays, this provider initially charges $151. This is lower 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Genomic Health, Inc. | Redwood City, CA | $887.6M | ✓ Clear |
| Unilab Corporation | West Hills, CA | $868.8M | ⚠️ Flagged |
| Caredx Inc. | Brisbane, CA | $751.0M | ✓ Clear |
| Laboratory Corporation Of America | San Diego, CA | $592.4M | ⚠️ Flagged |
| Millennium Health, Llc | San Diego, CA | $587.9M | ✓ 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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