This provider averages 130 services per working day
Based on 129.6K total services over 4 years (250 working days/year). Learn about impossible service volumes →
This provider's $5.5M in total Medicare payments ranks in the 99th percentile of Pathology providers nationally.
Averaging 130 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 1468% from 2016 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1750% in 2023
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 |
|---|---|---|---|---|---|---|---|
| 2016 | $268.64 | $75.87 | 3.54x | $192.77 | $281.8K | 3.7K | 8 |
| 2017 | $245.50 | $65.64 | 3.74x | $179.86 | $521.8K | 7.9K | 11 |
| 2018 | $369.29 | $77.92 | 4.74x | $291.37 | $238.7K | 3.1K | 10 |
| 2023 | $56.91 | $38.46 | 1.48x | $18.45 | $4.4M | 114.9K | 34 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | 11.1K | $1.6M | $139.78 | 1.43x |
| 87798 | Detection test by nucleic acid for organism, amplified probe technique | 35.9K | $1.2M | $34.39 | 1.61x |
| 87801 | Detection test by nucleic acid for multiple organisms, amplified probe(s) technique | 8.2K | $562.1K | $68.80 | 1.24x |
| 87481 | Detection test for candida species (yeast), amplified probe technique | 12.8K | $435.0K | $33.93 | 1.13x |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 8.2K | $352.1K | $43.17 | 4.39x |
| 88120 | Cell examination of urine | 395 | $202.9K | $513.70 | 3.21x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 401 | $135.3K | $337.43 | 4.26x |
| 88344 | Special stained specimen slides to examine tissue | 929 | $130.7K | $140.68 | 3.11x |
| 87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 2.7K | $94.0K | $34.39 | 1.74x |
| 87641 | Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique | 2.7K | $93.5K | $34.39 | 1.74x |
| 87651 | Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique | 2.7K | $93.5K | $34.39 | 1.60x |
| 87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 2.7K | $93.4K | $34.39 | 1.60x |
| 87653 | Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique | 2.5K | $86.7K | $34.39 | 1.60x |
| 88112 | Cell examination of specimen | 984 | $55.4K | $56.32 | 3.35x |
| 88108 | Cell examination of specimen | 1.5K | $54.1K | $36.76 | 5.43x |
| 87507 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 12-25 targets | 120 | $48.8K | $406.93 | 2.80x |
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 29.5K | $32.1K | $1.09 | 1.03x |
| 88342 | Tissue or cell analysis by immunologic technique | 552 | $31.7K | $57.35 | 3.90x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 988 | $30.2K | $30.55 | 3.76x |
| 87506 | Detection test by nucleic acid for digestive tract pathogen, multiple types or subtypes, 6-11 targets | 113 | $29.1K | $257.73 | 3.88x |
This provider submits charges 1.94 times higher than what Medicare actually pays.
A markup ratio of 1.94x means for every $100 Medicare pays, this provider initially charges $194. 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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