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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodologyโ€ขDownload Data
  1. Home
  2. Providers
  3. Exact Sciences Laboratories, Llc
๐Ÿ”ฌ
Organization

Exact Sciences Laboratories, Llc

NPI: 1629407069
Madison, WI
10 years of data
Clinical Laboratory
$1.6B
Total Payments
10
Beneficiaries
3.3M
Services
1.33x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$1.6B
Specialty median$1.9M
Rank #2 of 232 in specialty

๐Ÿ“‹ Key Findings

1Billed $1.6B over 10 years
2Risk score: 75 โ€” flagged for review
399th percentile in Clinical Laboratory by payments
4Payments surged 2221% in 2015

โš ๏ธ Flagged for Review

Risk Score: 75
  • 2890x specialty median spending
  • 412x specialty median beneficiaries
  • 184x specialty median services
View Deep Dives โ†’Report Fraud โ†’

Statistical flag only โ€” not an accusation of fraud

๐Ÿ”Ž Data Analysis

This provider's $1.6B in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.

Medicare payments to this provider grew 24893% from 2014 to 2023.

98% of their billing comes from a single procedure code (81528 โ€” Gene analysis (colorectal cancer)).

This provider has been statistically flagged with a risk score of 75/100. Statistical flags are not accusations of fraud.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

๐Ÿ“ˆ

Notable: Payments increased 2221% in 2015

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

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

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$599.00$482.721.24x$116.28$1.2M2.5K1
2015$631.28$482.721.31x$148.56$27.8M57.6K1
2016$649.00$498.311.30x$150.69$61.7M123.7K1
2017$649.00$501.631.29x$147.37$116.1M231.5K1
2018$649.00$498.461.30x$150.54$166.7M334.4K1
2019$649.00$498.511.30x$150.49$240.2M481.8K1
2020$657.64$505.351.30x$152.29$208.5M412.5K1
2021$677.29$508.711.33x$168.58$251.7M494.8K1
2022$681.00$502.131.36x$178.87$267.6M533.0K1
2023$681.00$498.521.37x$182.48$299.3M600.4K1

Top Procedures (2)

81528Gene analysis (colorectal cancer)
$1.6B
3.2M services$501.77/svc1.33x markup
G0464Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)
$29.0M
60.1K services$482.72/svc1.30x markup
Show detailed table โ–พ
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
81528Gene analysis (colorectal cancer)3.2M$1.6B$501.771.33x
G0464Colorectal cancer screening; stool-based dna and fecal occult hemoglobin (e.g., kras, ndrg4 and bmp3)60.1K$29.0M$482.721.30x

Markup Analysis

Charge-to-Payment Ratio

1.33x

This provider submits charges 1.33 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.33x means for every $100 Medicare pays, this provider initially charges $133. This is lower than the national average.

Location

Madison, WI

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 WI for peer comparison.

Exact Sciences Laboratories, Llc (you)
$1.6B
A2cl Services, Llcโš ๏ธ
$221.3M
Marshfield Clinic Inc
$44.5M
Wisconsin Diagnostic Laboratories Llc
$36.3M
Show detailed table โ–พ
ProviderLocationTotal PaymentsStatus
A2cl Services, LlcWest Allis, WI$221.3Mโš ๏ธ Flagged
Marshfield Clinic IncMarshfield, WI$44.5Mโœ“ Clear
Wisconsin Diagnostic Laboratories LlcMilwaukee, WI$36.3Mโœ“ Clear

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Data Sources

  • โ€ข Centers for Medicare & Medicaid Services (CMS)
  • โ€ข Medicare Provider Utilization and Payment Data (2014-2023)
  • โ€ข 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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