This provider's $246.3M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $265.16 | $52.20 | 5.08x | $212.96 | $30.9M | 592.4K | 51 |
| 2015 | $273.14 | $53.31 | 5.12x | $219.83 | $31.8M | 596.0K | 53 |
| 2016 | $288.65 | $58.39 | 4.94x | $230.26 | $33.9M | 580.1K | 52 |
| 2017 | $263.69 | $55.18 | 4.78x | $208.51 | $32.1M | 582.0K | 59 |
| 2018 | $259.49 | $56.39 | 4.60x | $203.10 | $32.5M | 575.6K | 59 |
| 2019 | $259.18 | $54.92 | 4.72x | $204.26 | $25.9M | 471.0K | 55 |
| 2020 | $258.48 | $55.30 | 4.67x | $203.18 | $16.6M | 300.9K | 53 |
| 2021 | $223.65 | $51.98 | 4.30x | $171.67 | $18.8M | 362.2K | 52 |
| 2022 | $230.24 | $50.33 | 4.57x | $179.91 | $12.9M | 257.0K | 52 |
| 2023 | $218.87 | $49.67 | 4.41x | $169.20 | $10.9M | 220.2K | 47 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 2.5M | $114.5M | $45.56 | 6.24x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 282.3K | $20.4M | $72.34 | 3.40x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 356.1K | $16.4M | $46.01 | 3.34x |
| 88377 | Microscopic genetic analysis of tissue, manual, each additional multiplex stain procedure | 52.0K | $13.9M | $266.88 | 2.43x |
| 88185 | Flow cytometry technique for dna or cell analysis, each additional marker | 437.6K | $12.8M | $29.16 | 4.58x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 163.3K | $9.6M | $58.59 | 3.14x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 133.0K | $8.3M | $62.28 | 3.30x |
| 88360 | Microscopic genetic analysis of tumor, manual | 70.0K | $6.2M | $88.92 | 3.37x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 13.8K | $4.3M | $310.42 | 6.95x |
| 88189 | Flow cytometry technique for dna or cell analysis, 16 or more markers | 49.6K | $3.7M | $75.57 | 3.61x |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 38.7K | $3.1M | $79.46 | 1.84x |
| 88368 | Microscopic genetic analysis of tissue, manual, initial procedure | 23.1K | $2.8M | $121.66 | 4.04x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 45.5K | $2.8M | $61.42 | 4.41x |
| 88237 | Tissue culture for tumor disorders of bone marrow and blood cells | 16.4K | $2.6M | $156.66 | 3.50x |
| 81479 | Molecular pathology procedure | 3.0K | $2.4M | $802.70 | 1.99x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 41.7K | $1.9M | $44.35 | 5.85x |
| 88365 | Genetic sequencing localization, initial procedure | 10.5K | $1.3M | $124.87 | 2.56x |
| 88112 | Cell examination of specimen, selective cellular enhancement technique | 25.5K | $1.3M | $49.89 | 5.63x |
| 88264 | Chromosome analysis for genetic defects, analyze 20-25 cells | 8.7K | $1.3M | $146.78 | 3.37x |
| 88120 | Cell examination of urine, manual | 2.6K | $1.3M | $489.18 | 2.79x |
This provider submits charges 4.78 times higher than what Medicare actually pays.
A markup ratio of 4.78x means for every $100 Medicare pays, this provider initially charges $478. 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Clinical Pathology Laboratories, Inc. | Austin, TX | $541.0M | ⚠️ Flagged |
| Quest Diagnostics Clinical Laboratories Inc | Irving, TX | $453.2M | ⚠️ Flagged |
| Laboratory Corporation Of America | Dallas, TX | $389.6M | ⚠️ Flagged |
| Quest Diagnostics Clinical Laboratories Inc | Houston, TX | $311.2M | ⚠️ Flagged |
| Laboratory Corporation Of America | Houston, TX | $299.4M | ⚠️ Flagged |
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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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