This provider's $11.1M in total Medicare payments ranks in the 91th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 8.31x is significantly above the specialty median of 3.7x.
Medicare payments to this provider grew 126% from 2015 to 2023.
75% of their billing comes from a single procedure code (G0483 — Drug test def 22+ classes).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 275% in 2016
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 | $79.21 | $21.50 | 3.68x | $57.71 | $414.8K | 21.3K | 16.0K |
| 2016 | $258.03 | $24.83 | 10.39x | $233.20 | $1.6M | 26.1K | 22.3K |
| 2017 | $207.23 | $25.22 | 8.22x | $182.01 | $1.1M | 22.5K | 20.1K |
| 2018 | $223.97 | $25.46 | 8.80x | $198.51 | $1.2M | 15.8K | 12.9K |
| 2019 | $231.61 | $24.93 | 9.29x | $206.68 | $1.3M | 19.8K | 16.6K |
| 2020 | $183.58 | $27.23 | 6.74x | $156.35 | $1.7M | 14.1K | 7.8K |
| 2021 | $150.91 | $42.41 | 3.56x | $108.50 | $1.7M | 13.4K | 6.1K |
| 2022 | $185.27 | $44.33 | 4.18x | $140.94 | $1.2M | 8.5K | 3.5K |
| 2023 | $472.50 | $152.34 | 3.10x | $320.16 | $936.1K | 4.4K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G0483 | Drug test def 22+ classes | 32.1K | $7.7M | $239.28 | 9.00x |
| 80307 | Testing for presence of drug | 9.8K | $618.7K | $62.93 | 8.51x |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 5.9K | $505.0K | $86.15 | 5.80x |
| 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 | 4.3K | $253.8K | $58.87 | 14.31x |
| G0480 | Drug test def 1-7 classes | 1.8K | $201.4K | $112.94 | 4.82x |
| G0482 | Drug test def 15-21 classes | 921 | $180.3K | $195.74 | 6.50x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 4.3K | $89.5K | $20.63 | 5.53x |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within | 3.0K | $75.8K | $25.00 | 4.00x |
| G0481 | Drug test def 8-14 classes | 472 | $71.5K | $151.44 | 12.31x |
| 82306 | Vitamin D-3 level | 2.0K | $67.2K | $34.39 | 5.87x |
| 80053 | Blood test, comprehensive group of blood chemicals | 5.4K | $61.5K | $11.38 | 6.33x |
| 82670 | Estradiol (hormone) level | 1.6K | $55.6K | $35.15 | 5.41x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 3.8K | $52.3K | $13.87 | 6.56x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 5.2K | $49.6K | $9.56 | 5.54x |
| 84403 | Testosterone (hormone) level | 1.2K | $41.6K | $33.45 | 5.26x |
| 84270 | Sex hormone binding globulin (protein) level | 1.3K | $37.6K | $28.35 | 5.22x |
| G6055 | Nicotine | 1.2K | $36.4K | $31.53 | 3.33x |
| G6045 | Dihydrocodeinone | 1.3K | $35.7K | $27.50 | 3.32x |
| 82627 | Dehydroepiandrosterone (DHEA-S) hormone level | 1.3K | $34.7K | $27.66 | 6.22x |
| G6056 | Opiate(s), drug and metabolites, each procedure | 1.3K | $33.7K | $25.92 | 3.40x |
This provider submits charges 8.31 times higher than what Medicare actually pays.
A markup ratio of 8.31x means for every $100 Medicare pays, this provider initially charges $831. 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 TX for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Clinical Pathology Laboratories, Inc. | Austin, TX | $541.0M | ⚠️ Flagged |
| Quest Diagnostics Clinical Laboratories Inc | Irving, TX | $453.2M | ⚠️ Flagged |
| Laboratory Corporation Of America | Dallas, TX | $389.6M | ⚠️ Flagged |
| Quest Diagnostics Clinical Laboratories Inc | Houston, TX | $311.2M | ⚠️ Flagged |
| Laboratory Corporation Of America | Houston, TX | $299.4M | ⚠️ Flagged |
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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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