This provider's $53.1M in total Medicare payments ranks in the 98th percentile of Clinical Laboratory providers nationally.
73% 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.
Notable: Payments increased 147% in 2015
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 | $168.48 | $50.91 | 3.31x | $117.57 | $4.4M | 86.5K | 8 |
| 2015 | $114.40 | $36.93 | 3.10x | $77.47 | $10.9M | 294.5K | 41 |
| 2016 | $392.00 | $89.94 | 4.36x | $302.06 | $11.2M | 124.3K | 30 |
| 2017 | $156.62 | $49.81 | 3.14x | $106.81 | $4.2M | 84.6K | 11 |
| 2018 | $160.46 | $51.27 | 3.13x | $109.19 | $3.9M | 76.3K | 10 |
| 2019 | $157.64 | $50.18 | 3.14x | $107.46 | $4.0M | 79.5K | 10 |
| 2020 | $155.52 | $51.62 | 3.01x | $103.90 | $3.4M | 66.1K | 11 |
| 2021 | $156.49 | $53.46 | 2.93x | $103.03 | $3.6M | 67.8K | 11 |
| 2022 | $150.55 | $50.74 | 2.97x | $99.81 | $3.8M | 74.0K | 10 |
| 2023 | $152.40 | $50.53 | 3.02x | $101.87 | $3.8M | 74.6K | 10 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 714.9K | $36.2M | $50.69 | 3.03x |
| G0483 | Drug test def 22+ classes | 5.9K | $1.2M | $210.02 | 9.42x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 15.9K | $1.2M | $78.13 | 2.68x |
| 81435 | Test for detecting genes associated with colon cancer | 1.4K | $1.1M | $771.19 | 2.58x |
| 88350 | Antibody evaluation, each additional single antibody stain procedure | 12.8K | $935.0K | $72.89 | 3.29x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 28.9K | $878.0K | $30.39 | 3.10x |
| G6056 | Opiate(s), drug and metabolites, each procedure | 27.7K | $717.2K | $25.86 | 3.51x |
| 81436 | Test for detecting genes associated with colon cancer | 898 | $697.3K | $776.54 | 2.57x |
| 88346 | Antibody evaluation, initial single antibody stain procedure | 7.2K | $641.7K | $88.79 | 2.75x |
| 81214 | Gene analysis (breast cancer 1) full sequence and common duplication or deletion variants | 455 | $638.4K | $1.4K | 2.56x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 9.3K | $628.3K | $67.74 | 3.71x |
| 81437 | Gene analysis (neuroendocrine tumors), genomic sequence | 958 | $603.1K | $629.55 | 6.17x |
| 81432 | Gene analysis (breast and related cancers), genomic sequence | 959 | $602.3K | $628.03 | 9.40x |
| 82542 | Chemical analysis using chromatography technique | 24.1K | $579.1K | $23.98 | 3.07x |
| 81438 | Gene analysis (neuroendocrine tumors), duplication and deletion variants | 896 | $563.5K | $628.88 | 2.57x |
| 81433 | Gene analysis (breast and related cancers), duplication or deletion variants | 897 | $561.9K | $626.37 | 2.58x |
| 83789 | Mass spectrometry (laboratory testing method) | 20.1K | $483.3K | $23.98 | 3.48x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 5.1K | $393.5K | $77.60 | 3.17x |
| G0482 | Drug test def 15-21 classes | 2.2K | $363.8K | $162.04 | 9.01x |
| G6031 | Benzodiazepines | 14.0K | $344.4K | $24.59 | 3.52x |
This provider submits charges 3.36 times higher than what Medicare actually pays.
A markup ratio of 3.36x means for every $100 Medicare pays, this provider initially charges $336. 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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