This provider's $536.1M in total Medicare payments ranks in the 99th percentile of Clinical Laboratory providers nationally.
Medicare payments to this provider grew 64% from 2014 to 2023.
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 | $1.6K | $950.20 | 1.63x | $601.54 | $40.2M | 42.3K | 16 |
| 2015 | $1.7K | $1.1K | 1.50x | $562.78 | $47.3M | 41.7K | 17 |
| 2016 | $2.2K | $1.4K | 1.54x | $779.54 | $44.9M | 31.1K | 19 |
| 2017 | $2.4K | $1.6K | 1.54x | $848.23 | $45.8M | 29.0K | 16 |
| 2018 | $2.6K | $1.7K | 1.52x | $893.01 | $51.0M | 29.7K | 17 |
| 2019 | $2.7K | $1.6K | 1.67x | $1.1K | $57.3M | 35.8K | 18 |
| 2020 | $3.5K | $2.1K | 1.67x | $1.4K | $56.7M | 27.1K | 15 |
| 2021 | $4.0K | $2.4K | 1.66x | $1.6K | $63.7M | 26.3K | 9 |
| 2022 | $4.2K | $2.4K | 1.76x | $1.8K | $63.3M | 26.6K | 8 |
| 2023 | $3.9K | $1.9K | 2.04x | $2.0K | $65.9M | 34.8K | 7 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 81162 | Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion variants | 92.9K | $189.6M | $2.0K | 1.98x |
| 81541 | Gene analysis of prostate tumor tissue, profiling by real-time rt-pcr of 46 genes | 38.1K | $145.1M | $3.8K | 1.02x |
| 81479 | Molecular pathology procedure | 35.0K | $69.5M | $2.0K | 2.47x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 32.7K | $66.6M | $2.0K | 1.62x |
| 81213 | Gene analysis (breast cancer 1 and 2) uncommon duplication or deletion variants | 34.5K | $19.6M | $567.89 | 1.23x |
| 0172U | Dna gene analysis (brca1, dna repair associated and brca2, dna repair associated) for detection of mutations associated with breast cancer | 4.0K | $12.4M | $3.1K | 1.31x |
| 81317 | Gene analysis (postmeiotic segregation increased 2 [s cerevisiae]) full sequence analysis | 8.4K | $6.1M | $728.46 | 1.24x |
| 81292 | Gene analysis (mutl homolog 1, colon cancer, nonpolyposis type 2) full sequence analysis | 9.1K | $5.8M | $642.32 | 1.41x |
| 81298 | Gene analysis (muts homolog 6 [e coli]) full sequence analysis | 8.4K | $3.4M | $411.39 | 2.12x |
| 81522 | Mrna gene expression analysis of 12 genes in breast tumor tissue | 592 | $2.3M | $3.8K | 1.02x |
| 81295 | Gene analysis (muts homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis | 8.3K | $1.9M | $233.18 | 3.14x |
| 81319 | Gene analysis (postmeiotic segregation increased 2 [s cerevisiae]) duplication or deletion variants | 8.4K | $1.8M | $209.91 | 1.29x |
| 81294 | Gene analysis (mutl homolog 1, colon cancer, nonpolyposis type 2) duplication or deletion variants | 9.0K | $1.7M | $190.89 | 1.41x |
| 81599 | Multianalyte assay procedure with algorithmic analysis | 500 | $1.7M | $3.4K | 1.11x |
| 81300 | Gene analysis (muts homolog 6 [e coli]) duplication or deletion variants | 8.3K | $1.5M | $185.88 | 1.45x |
| 81297 | Gene analysis (muts homolog 2, colon cancer, nonpolyposis type 1) duplication or deletion variants | 8.3K | $1.4M | $170.83 | 1.58x |
| 81212 | Gene analysis (breast cancer 1 and 2) for 185delag, 5385insc, 6174delt variants | 5.6K | $1.4M | $246.49 | 2.33x |
| 0090U | Mrna gene expression profiling of 23 genes in skin melanoma tissue sample | 695 | $1.3M | $1.8K | 1.06x |
| 88381 | Preparation of specimen, manual | 8.3K | $1.2M | $146.36 | 1.40x |
| 81164 | Gene analysis (breast cancer 1 and 2) for duplication or deletion variants | 1.1K | $651.0K | $576.08 | 1.22x |
This provider submits charges 1.67 times higher than what Medicare actually pays.
A markup ratio of 1.67x means for every $100 Medicare pays, this provider initially charges $167. 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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