This provider's $4.3M in total Medicare payments ranks in the 78th percentile of Clinical Laboratory providers nationally.
66% of their billing comes from a single procedure code (88120 — Cell examination of urine).
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 | $937.89 | $336.88 | 2.78x | $601.01 | $385.7K | 788 | 611 |
| 2015 | $517.26 | $202.19 | 2.56x | $315.07 | $550.8K | 2.5K | 2.0K |
| 2016 | $566.67 | $227.45 | 2.49x | $339.22 | $544.3K | 2.7K | 2.1K |
| 2017 | $704.98 | $213.03 | 3.31x | $491.95 | $433.0K | 2.4K | 2.0K |
| 2018 | $896.43 | $189.50 | 4.73x | $706.93 | $430.6K | 2.3K | 1.9K |
| 2019 | $896.43 | $174.58 | 5.13x | $721.85 | $337.1K | 2.1K | 1.8K |
| 2020 | $610.34 | $129.07 | 4.73x | $481.27 | $393.2K | 3.3K | 2.7K |
| 2021 | $407.11 | $98.88 | 4.12x | $308.23 | $483.2K | 3.9K | 3.1K |
| 2022 | $627.44 | $138.88 | 4.52x | $488.56 | $390.8K | 2.6K | 2.1K |
| 2023 | $414.05 | $93.15 | 4.44x | $320.90 | $381.2K | 2.6K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88120 | Cell examination of urine | 5.3K | $2.9M | $535.90 | 3.39x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 1.9K | $501.7K | $267.57 | 6.47x |
| 88112 | Cell examination of specimen | 7.6K | $338.3K | $44.43 | 6.02x |
| 88108 | Cell examination of specimen | 4.2K | $169.0K | $40.15 | 4.17x |
| 88377 | Microscopic genetic examination manual | 391 | $130.5K | $333.78 | 3.24x |
| 88344 | Special stained specimen slides to examine tissue | 734 | $97.8K | $133.25 | 4.18x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1.2K | $56.7K | $46.34 | 3.53x |
| 87801 | Detection test for multiple organisms | 646 | $45.2K | $70.04 | 2.51x |
| 87640 | Detection test for staphylococcus aureus (bacteria) | 712 | $24.9K | $34.99 | 2.51x |
| 87798 | Detection test for organism | 710 | $24.8K | $34.99 | 2.51x |
| 87500 | Detection test for vancomycin resistance strep (vre) | 648 | $22.7K | $35.01 | 2.51x |
| 88121 | Cell examination of urine, computer-assisted | 43 | $16.2K | $377.77 | 5.03x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 355 | $12.4K | $34.91 | 2.51x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 355 | $12.4K | $34.91 | 2.51x |
| 88367 | Microscopic genetic analysis of tissue | 23 | $4.0K | $174.87 | 2.14x |
| 88342 | Tissue or cell analysis by immunologic technique | 54 | $3.8K | $71.28 | 3.71x |
| 88341 | Special stained specimen slides to examine tissue | 49 | $3.2K | $65.60 | 3.05x |
| 87529 | Detection test by nucleic acid for herpes simplex virus, amplified probe technique | 44 | $1.5K | $34.77 | 2.52x |
| 87511 | Detection test for gardnerella vaginalis (bacteria), amplified probe technique | 44 | $1.5K | $34.77 | 2.52x |
| 87491 | Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | 43 | $1.5K | $34.78 | 2.52x |
This provider submits charges 3.97 times higher than what Medicare actually pays.
A markup ratio of 3.97x means for every $100 Medicare pays, this provider initially charges $397. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Massachusetts Llc | Marlborough, MA | $276.5M | ⚠️ Flagged |
| Quest Diagnostics Llc | Marlborough, MA | $268.6M | ⚠️ Flagged |
| Foundation Medicine, Inc. | Cambridge, MA | $232.3M | ✓ Clear |
| Boston Heart Diagnostics Corporation | Framingham, MA | $185.1M | ✓ Clear |
| Cohen Dermatopathology, P.C. | Needham, MA | $88.9M | ✓ 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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