This provider's $74.4M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
89% 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 | $130.46 | $53.09 | 2.46x | $77.37 | $5.7M | 107.5K | 8 |
| 2015 | $130.62 | $56.13 | 2.33x | $74.49 | $6.5M | 116.0K | 9 |
| 2016 | $132.22 | $58.45 | 2.26x | $73.77 | $6.9M | 117.4K | 9 |
| 2017 | $130.36 | $54.63 | 2.39x | $75.73 | $6.5M | 118.8K | 10 |
| 2018 | $130.59 | $55.51 | 2.35x | $75.08 | $7.2M | 129.5K | 10 |
| 2019 | $130.99 | $55.71 | 2.35x | $75.28 | $8.5M | 151.8K | 10 |
| 2020 | $131.44 | $57.63 | 2.28x | $73.81 | $7.5M | 131.0K | 14 |
| 2021 | $131.23 | $58.36 | 2.25x | $72.87 | $8.8M | 151.6K | 11 |
| 2022 | $130.54 | $58.33 | 2.24x | $72.21 | $8.4M | 144.1K | 12 |
| 2023 | $128.73 | $56.06 | 2.30x | $72.67 | $8.3M | 148.6K | 11 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1.2M | $66.4M | $55.54 | 2.38x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 35.4K | $3.0M | $84.47 | 1.46x |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 20.8K | $1.8M | $84.76 | 1.75x |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 19.4K | $1.4M | $74.07 | 1.99x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 37.0K | $1.2M | $33.22 | 2.24x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 2.4K | $146.7K | $60.49 | 1.47x |
| 88321 | Surgical pathology consultation and report on referred slides prepared elsewhere | 1.2K | $100.5K | $81.51 | 1.84x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 1.8K | $99.7K | $55.71 | 2.70x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 1.4K | $93.8K | $69.42 | 2.09x |
| 88323 | Surgical pathology consultation and report on referred material requiring preparation of slides | 525 | $49.9K | $95.01 | 1.88x |
| 88302 | Pathology examination of tissue using a microscope | 621 | $16.1K | $25.91 | 2.17x |
| 88365 | Genetic sequencing localization, initial procedure | 202 | $12.1K | $59.77 | 3.22x |
| 88374 | Microscopic genetic examination using computer-assisted technology | 38 | $11.4K | $299.22 | 2.35x |
| 88364 | Genetic sequencing localization, each additional procedure | 197 | $8.8K | $44.75 | 3.99x |
| 88346 | Antibody evaluation, initial single antibody stain procedure | 79 | $7.0K | $89.04 | 1.50x |
| 88350 | Antibody evaluation, each additional single antibody stain procedure | 65 | $6.6K | $101.21 | 1.32x |
| 88360 | Microscopic genetic analysis of tumor | 55 | $5.9K | $108.12 | 1.34x |
| 88300 | Pathology examination of tissue using a microscope, limited examination | 41 | $520.44 | $12.69 | 2.88x |
| 87168 | Macroscopic examination (visual inspection) of insect | 33 | $140.64 | $4.26 | 3.99x |
This provider submits charges 2.31 times higher than what Medicare actually pays.
A markup ratio of 2.31x means for every $100 Medicare pays, this provider initially charges $231. 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 PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Clinical Laboratories Inc | Norristown, PA | $340.6M | ✓ Clear |
| Quest Diagnostics Of Pennsylvania, Inc. | Pittsburgh, PA | $130.4M | ⚠️ Flagged |
| Health Network Laboratories, Llc | Allentown, PA | $125.3M | ⚠️ Flagged |
| Sma Medical, Inc. | Feasterville, PA | $100.9M | ✓ Clear |
| Interpace Diagnostics Corporation | Pittsburgh, PA | $95.6M | ✓ 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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