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NPI 1013973866 · Phoenix, AZ · Clinical Medical Laboratory
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Caris Mpi, Inc. is a clinical medical laboratory provider located in Phoenix, Arizona. This profile covers 8 Medicare and 59 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Caris Mpi, Inc. |
| Address | 4610 South 44th Place |
| City | Phoenix |
| State | AZ |
| ZIP | 85040 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 21, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $97.4M |
| Medicaid | $51.7M |
CARIS MPI, INC. is a laboratory-focused operation concentrated on high-complexity molecular and pathology testing: Medicare top codes show the provider derives the majority of its Medicare revenue from molecular pathology and pathology slide staining/microdissection procedures, with 81479, 88360 and 88341 accounting for 95.9% of its Medicare revenue. The prominence of 81479 (a catch-all molecular pathology code) together with heavy volumes of immunohistochemistry codes 88360 and 88341 indicates the business model centers on centralized molecular diagnostics and high-volume slide-based pathology support.
Medicare revenue is substantial relative to Medicaid: lifetime Medicare revenue is $97.4M versus $51.7M in Medicaid, so this entity has material scale in both public payers but more than 1.8x as much revenue from Medicare as from Medicaid. That payer mix suggests significant engagement with fee-for-service Medicare referrals while maintaining a large Medicaid testing footprint that supports its molecular testing capacity.
Revenue concentration is extreme on the Medicare side: the precomputed top-3 Medicare codes account for 95.9% of the provider’s total Medicare revenue, indicating Medicare earnings are highly dependent on 81479, 88360 and 88341. Such concentration implies business risk if reimbursement or utilization for those specific codes changes, and conversely suggests operational specialization that likely optimizes processes and billing for those procedures.
National competitive standing on key Medicare codes is outsized: the provider ranks #3 nationally for 81479 (97th percentile) and ranks #1 nationally for both 88360 and 88341 (100th percentile), with the dataset labeling its volumes as “notably above typical” for 81479 and “extreme outlier” for the two immunostain codes. These rankings identify CARIS MPI as a major national supplier of molecular pathology and high-volume immunohistochemistry services relative to peers, not just a regional lab.
State-level Medicaid dominance for genetic testing and pathology: in Arizona the provider ranks #1 for many high-revenue Medicaid codes (including 81408, 81479, 88360, 88341 and numerous single-gene and panel codes) and is often the only in-state reporter for several genetic sequencing CPTs. Several of those in-state rankings are annotated as 100th percentile or lack state peers, which together portray CARIS MPI as a dominant or sole provider of many specialized molecular tests in AZ Medicaid.
Medicaid revenue is more diversified across molecular panel and single-gene codes than Medicare: the top 3 Medicaid codes account for 32.7% of Medicaid revenue, and the Medicaid top-25 list shows many distinct genetic sequencing and panel codes (e.g., 81408, 81479, 81321, 81163, 81455) contributing material shares. This distribution suggests the Medicaid book comprises a broader menu of discrete genetic tests and panels, rather than being concentrated in a few catch-all codes.
Several Medicare and Medicaid codes are flagged as extreme outliers in volume, indicating unusually high utilization relative to peers: on Medicare the provider is a 100th-percentile outlier for 88360, 88341, 88381 and 88365; in-state Medicaid volumes for many genetic codes are likewise denoted as extreme outlier or sole-provider. These labels point to atypically large throughput for slide-based pathology services and broad molecular sequencing workstreams.
The provider has longstanding enrollment: the NPI was enumerated on 2006-04-21 (≈20 years ago), indicating long tenure in Medicare/Medicaid billing. That longevity, combined with concentrated specialty volumes and dominant rankings, suggests established referral or contracting relationships that have scaled its molecular and pathology testing business over time.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 25,030 | $3,380 | $84.7M |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 80,530 | $70 | $5.7M |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 56,590 | $50 | $3M |
| 88381 | A clinician, typically a pathologist, performs a manual microdissection of a patient’s specimen, such as a biopsy or tissue preserved from a previous case. | 19,060 | $120 | $2.2M |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 19,090 | $60 | $1.2M |
| 88377 | The lab analyst applies a single multiplex in situ hybridization probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 1,770 | $230 | $397.4K |
| 88365 | The lab analyst applies an initial in situ hybridization single probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 1,540 | $110 | $163.5K |
| 81287 | A lab performs O–6–methylguanine–DNA methyltransferase (MGMT) promoter methylation analysis, typically as a prognostic marker for responsiveness of glioblastoma (brain tumor) to alkylating… | 390 | $120 | $47.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
View: State1 / 2
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
59 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81408 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code. | 17,470 | $320 | $5.6M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 21,150 | $220 | $4.6M |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 45,010 | $70 | $3.3M |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 34,920 | $50 | $1.9M |
| 81321 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the phosphatase and tensin homolog, or PTEN, gene. | 16,440 | $110 | $1.8M |
| 81163 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1 DNA repair–associated gene, also known as BRCA1, and the BRCA2 DNA repair–associated gene, also known… | 13,560 | $130 | $1.8M |
| 81455 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as tumor tissue or bone marrow, for DNA and possibly RNA alterations in 51 or more genes known to… | 5,330 | $320 | $1.7M |
| 81404 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 5 molecular pathology code. | 18,030 | $90 | $1.6M |
| 81292 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutL homolog 1, or MLH1 gene, also known as the colon cancer or nonpolyposis type 2 gene. | 12,470 | $120 | $1.5M |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 18,010 | $80 | $1.5M |
Showing 1–10 of 59
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
59 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81408 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code. | 1 | 10 | 17,470 | $320 | $5.6M |
| 81321 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the phosphatase and tensin homolog, or PTEN, gene. | 1 | 10 | 16,440 | $110 | $1.8M |
| 81163 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1 DNA repair–associated gene, also known as BRCA1, and the BRCA2 DNA repair–associated gene, also known… | 1 | 10 | 13,560 | $130 | $1.8M |
| 81404 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 5 molecular pathology code. | 1 | 10 | 18,030 | $90 | $1.6M |
| 81292 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutL homolog 1, or MLH1 gene, also known as the colon cancer or nonpolyposis type 2 gene. | 1 | 10 | 12,470 | $120 | $1.5M |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 1 | 10 | 18,010 | $80 | $1.5M |
| 81201 | The lab analyst performs the technical lab test to analyze the entire gene sequence for adenomatous polyposis coli, also known as APC. | 1 | 10 | 11,050 | $130 | $1.4M |
| 81301 | The lab analyst performs the technical lab test to detect the presence of microsatellite instability, also known as MSI, in tumor cells from tissue specimens such as colon cancer. | 1 | 10 | 17,910 | $70 | $1.3M |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 1 | 10 | 12,950 | $90 | $1.2M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 1 | 10 | 1,340 | $200 | $1.2M |
Showing 1–10 of 59
Other providers in the same ZIP code as Caris Mpi, Inc., ranked by combined Medicare and Medicaid revenue.
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