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Methodology•Download Data
  1. Home
  2. Providers
  3. Pathology Reference Laboratory, L.L.C.
🔬
Organization

Pathology Reference Laboratory, L.L.C.

NPI: 1538157086
San Antonio, TX
10 years of data
Clinical Laboratory
$11.2M
Total Payments
194.4K
Beneficiaries
225.5K
Services
3.08x
Markup Ratio

Peer Comparison

91th
percentile in specialty
This provider$11.2M
Specialty median$1.9M

📋 Key Findings

1Billed $11.2M over 10 years
23.08x markup ratio (above median)
391th percentile in Clinical Laboratory by payments
45 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $11.2M in total Medicare payments ranks in the 91th 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.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$141.54$56.922.49x$84.62$1.4M29.8K25.8K
2015$129.84$57.922.24x$71.92$1.5M29.9K26.3K
2016$144.07$64.972.22x$79.10$1.3M25.4K22.7K
2017$146.36$66.902.19x$79.46$1.1M23.6K20.7K
2018$132.33$54.812.41x$77.52$1.1M22.5K19.6K
2019$138.18$52.552.63x$85.63$1.0M21.7K18.6K
2020$137.61$51.602.67x$86.01$968.3K18.8K15.9K
2021$150.47$60.032.51x$90.44$1.1M20.4K17.1K
2022$136.16$53.192.56x$82.97$976.8K18.5K15.5K
2023$173.11$68.562.52x$104.55$832.2K14.8K12.2K

Top Procedures (20)

88305Pathology examination of tissue using a microscope, intermediate complexity⚠ 4.3x markup
$4.2M
82.3K services$50.71/svc4.27x markup
88173Evaluation of fine needle aspirate with interpretation and report
$653.3K
5.7K services$114.39/svc1.92x markup
88342Tissue or cell analysis by immunologic technique
$571.8K
7.9K services$72.51/svc1.88x markup
88175Pap test
$551.9K
16.4K services$33.65/svc2.82x markup
87624Detection test for human papillomavirus (hpv)
$473.4K
10.8K services$43.67/svc1.83x markup
G0145Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision⚠ 3.1x markup
$454.7K
14.8K services$30.70/svc3.09x markup
88312Special stained specimen slides to identify organisms including interpretation and report
$439.7K
6.2K services$71.47/svc1.46x markup
88341Special stained specimen slides to examine tissue
$320.9K
4.8K services$66.50/svc2.10x markup
G0416Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens⚠ 4.0x markup
$295.2K
991 services$297.91/svc3.95x markup
88121Cell examination of urine
$294.0K
772 services$380.81/svc2.45x markup
88304Pathology examination of tissue using a microscope, moderately low complexity⚠ 4.7x markup
$257.8K
8.4K services$30.67/svc4.70x markup
U0003Infectious 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
$248.2K
2.9K services$85.19/svc1.47x markup
87661Detection test for Trichomonas vaginalis (genital parasite)
$156.2K
3.8K services$41.11/svc1.95x markup
88307Pathology examination of tissue using a microscope, moderately high complexity
$151.2K
730 services$207.10/svc1.54x markup
87481Detection test for candida species (yeast)
$136.7K
3.3K services$40.90/svc1.49x markup
88313Special stained specimen slides to examine tissue including interpretation and report
$127.8K
2.9K services$43.64/svc2.26x markup
87511Detection test for gardnerella vaginalis (bacteria)
$121.6K
2.9K services$42.60/svc1.41x markup
88120Cell examination of urine, manual
$108.3K
232 services$466.79/svc2.25x markup
87621Detection test for human papillomavirus (HPV)
$108.0K
2.3K services$46.76/svc2.01x markup
88172Evaluation of fine needle aspirate⚠ 4.1x markup
$99.1K
2.4K services$41.49/svc4.14x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
88305Pathology examination of tissue using a microscope, intermediate complexity82.3K$4.2M$50.714.27x
88173Evaluation of fine needle aspirate with interpretation and report5.7K$653.3K$114.391.92x
88342Tissue or cell analysis by immunologic technique7.9K$571.8K$72.511.88x
88175Pap test16.4K$551.9K$33.652.82x
87624Detection test for human papillomavirus (hpv)10.8K$473.4K$43.671.83x
G0145Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision14.8K$454.7K$30.703.09x
88312Special stained specimen slides to identify organisms including interpretation and report6.2K$439.7K$71.471.46x
88341Special stained specimen slides to examine tissue4.8K$320.9K$66.502.10x
G0416Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens991$295.2K$297.913.95x
88121Cell examination of urine772$294.0K$380.812.45x
88304Pathology examination of tissue using a microscope, moderately low complexity8.4K$257.8K$30.674.70x
U0003Infectious 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-r2.9K$248.2K$85.191.47x
87661Detection test for Trichomonas vaginalis (genital parasite)3.8K$156.2K$41.111.95x
88307Pathology examination of tissue using a microscope, moderately high complexity730$151.2K$207.101.54x
87481Detection test for candida species (yeast)3.3K$136.7K$40.901.49x
88313Special stained specimen slides to examine tissue including interpretation and report2.9K$127.8K$43.642.26x
87511Detection test for gardnerella vaginalis (bacteria)2.9K$121.6K$42.601.41x
88120Cell examination of urine, manual232$108.3K$466.792.25x
87621Detection test for human papillomavirus (HPV)2.3K$108.0K$46.762.01x
88172Evaluation of fine needle aspirate2.4K$99.1K$41.494.14x

Markup Analysis

Charge-to-Payment Ratio

3.08x

This provider submits charges 3.08 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.08x means for every $100 Medicare pays, this provider initially charges $308. This is higher than the national average.

Location

San Antonio, TX

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Clinical Laboratory providers in TX for peer comparison.

Pathology Reference Laboratory, L.L.C. (you)
$11.2M
Clinical Pathology Laboratories, Inc.⚠️
$541.0M
Quest Diagnostics Clinical Laboratories Inc⚠️
$453.2M
Laboratory Corporation Of America⚠️
$389.6M
Quest Diagnostics Clinical Laboratories Inc⚠️
$311.2M
Laboratory Corporation Of America⚠️
$299.4M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Clinical Pathology Laboratories, Inc.Austin, TX$541.0M⚠️ Flagged
Quest Diagnostics Clinical Laboratories IncIrving, TX$453.2M⚠️ Flagged
Laboratory Corporation Of AmericaDallas, TX$389.6M⚠️ Flagged
Quest Diagnostics Clinical Laboratories IncHouston, TX$311.2M⚠️ Flagged
Laboratory Corporation Of AmericaHouston, TX$299.4M⚠️ Flagged

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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