This provider's $29.5M in total Medicare payments ranks in the 97th 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.
Notable: Payments increased 1131% in 2018
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $43.78 | $21.06 | 2.08x | $22.72 | $547.1K | 14.3K | 6.8K |
| 2016 | $58.78 | $18.44 | 3.19x | $40.34 | $856.4K | 27.2K | 18.7K |
| 2017 | $91.62 | $18.96 | 4.83x | $72.66 | $849.3K | 39.0K | 28.3K |
| 2018 | $384.77 | $148.67 | 2.59x | $236.10 | $10.5M | 35.1K | 29.5K |
| 2019 | $262.55 | $174.17 | 1.51x | $88.38 | $16.7M | 38.9K | 36.5K |
| 2020 | $69.23 | $20.42 | 3.39x | $48.81 | $135.0K | 3.9K | 3.3K |
| 2021 | $66.67 | $34.33 | 1.94x | $32.34 | $19.9K | 417 | 338 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81408 | Molecular pathology procedure level 9 | 4.0K | $7.8M | $2.0K | 1.23x |
| 81201 | Gene analysis (adenomatous polyposis coli), full gene sequence | 4.5K | $3.4M | $764.40 | 1.79x |
| 81317 | Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis | 4.8K | $3.2M | $674.61 | 2.03x |
| 81298 | Gene analysis (mutS homolog 6 [E coli]) full sequence analysis | 4.5K | $2.9M | $629.01 | 1.45x |
| 81295 | Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis | 4.5K | $1.7M | $374.07 | 1.40x |
| 81325 | Gene analysis (peripheral myelin protein 22), full sequence analysis | 2.2K | $1.7M | $754.19 | 3.06x |
| 81259 | Gene analysis (alpha globin 1 and alpha globin 2) full sequence analysis | 2.3K | $1.3M | $588.00 | 1.25x |
| 81406 | Molecular pathology procedure level 7 | 3.5K | $958.1K | $277.22 | 1.22x |
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 364 | $723.3K | $2.0K | 1.35x |
| G0481 | Drug test def 8-14 classes | 4.2K | $564.7K | $135.72 | 3.31x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 203 | $476.6K | $2.3K | 2.69x |
| 81300 | Gene analysis (mutS homolog 6 [E coli]) duplication or deletion variants | 1.7K | $404.4K | $233.24 | 1.22x |
| 81319 | Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) duplication or deletion variants | 1.7K | $344.2K | $199.43 | 1.22x |
| 81203 | Gene analysis (adenomatous polyposis coli), duplication or deletion variants | 1.7K | $339.7K | $196.00 | 1.22x |
| 80307 | Testing for presence of drug | 3.9K | $284.6K | $72.24 | 4.31x |
| G0431 | Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter | 2.5K | $243.1K | $96.88 | 1.55x |
| G0480 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (an | 1.9K | $217.1K | $113.61 | 3.83x |
| G0479 | Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when | 2.4K | $189.0K | $77.65 | 3.12x |
| 81436 | Test for detecting genes associated with colon cancer | 294 | $187.2K | $636.89 | 1.22x |
| 81435 | Test for detecting genes associated with colon cancer | 277 | $176.4K | $636.89 | 1.22x |
This provider submits charges 1.83 times higher than what Medicare actually pays.
A markup ratio of 1.83x means for every $100 Medicare pays, this provider initially charges $183. This is lower than the national average.
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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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