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NPI 1033196001 · Research Triangle Park, NC · Clinical Medical Laboratory
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Laboratory Corporation Of America Holdings is a clinical medical laboratory provider located in Research Triangle Park, North Carolina. This profile covers 103 Medicare and 198 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 | Laboratory Corporation Of America Holdings |
| Address | 1904 Alexander Dr |
| City | Research Triangle Park |
| State | NC |
| ZIP | 27709 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | December 29, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $53.2M |
| Medicare | $2.7M |
LABORATORY CORPORATION OF AMERICA HOLDINGS is a long‑standing clinical medical laboratory based in RESEARCH TRIANGLE PARK, NC, with an NPI enumerated on 2005-12-29 (~21 years ago), indicating multi‑decade participation in Medicare and Medicaid billing and an established operational footprint in lab services. Its taxonomy as a Clinical Medical Laboratory aligns with the high volumes of molecular, cytogenetic, and infectious-disease testing observed across both payers.
Medicaid dominates this provider’s lifetime public‑payer revenue: total Medicaid revenue is $53.2M versus total Medicare revenue of $2.7M, indicating the provider’s billed services to state programs are an order of magnitude larger than its Medicare activity and that it functions effectively as a Medicaid‑scale lab in North Carolina.
Revenue concentration is high on both payers but differs by payer: precomputed figures show the top 3 Medicare codes account for 75.9% of total Medicare revenue, while the top 3 Medicaid codes account for 63.4% of total Medicaid revenue, signifying a small set of tests drive the majority of reimbursement for each payer.
Medicare top‑code 81479 (molecular pathology, unspecified) generates $1.3M and represents 48.6% of this provider’s Medicare revenue and ranks #9 of 80 nationally (90th percentile). This placement suggests the lab is a top national participant for higher‑level molecular pathology reporting, consistent with a centralized reference testing model that handles complex, uncoded molecular procedures.
On Medicare, the provider shows extreme national specialization in flow cytometry add‑on and interpretation codes: 88185 (38.5K claims, $616.8K, 22.8% of Medicare revenue) and 88189 (1.9K claims, $121.9K, 4.5% of Medicare revenue) both rank in the 99th percentile nationally and are labeled as extreme outliers. Those signals indicate unusually large volume relative to peers for flow‑cytometry technical and interpretation work, implying a substantial operational capacity or regional referral network for hematopathology testing.
State‑level Medicaid volumes position this lab as a dominant in‑state provider for several specialized assays. Notably, 81229 (CGH microarray) accounts for $10.9M (21.2% of Medicaid revenue) and ranks #1 of 10 in‑state (100th percentile), and U0003 (SARS‑CoV‑2 high throughput PCR) accounts for $13.6M (26.3% of Medicaid revenue) and ranks #5 of 158 (97th percentile). These rankings show the lab is a leading in‑state provider for prenatal microarray and high‑throughput COVID testing.
Additional Medicaid codes where the provider ranks as the top in‑state performer include 88185, 88262, 88230, 81206, 81270, 88189, and 88184 (each 100th‑percentile in‑state rank reported). Collectively these codes span flow cytometry, cytogenetics, and molecular diagnostics, reinforcing the profile of a centralized reference lab with high throughput for both genetic and hematopathology services.
While several Medicare codes are ranked highly nationally, many other listed Medicare CPT/HCPCS entries show typical or unremarkable national volume (for example 88237, 88275, 88271, and multiple gene‑specific tests), indicating that outside of a few very large national outliers the provider’s Medicare activity includes a broad mix of standard clinical genetics and pathology testing at expected peer levels. This mix supports a hybrid business model combining specialty high‑volume assays with routine diagnostic testing.
The combination of Medicaid dominance in revenue, repeated 100th‑percentile in‑state rankings for multiple specialized assays, and national 99th‑percentile Medicare ranks for key flow‑cytometry codes suggests the lab is both a major state‑level anchor for Medicaid testing in NC and a national referral destination for specific hematopathology and molecular procedures. That competitive standing is consistent with large reference‑lab scale and specialization rather than a small local lab.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
103 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. | 4,480 | $290 | $1.3M |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 38,550 | $20 | $616.8K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 1,940 | $60 | $121.9K |
| 81270 | The lab analyst performs the technical lab test to detect the presence of a common change in the gene for Janus kinase 2, also known as JAK2. | 1,000 | $90 | $89.6K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 620 | $140 | $87K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 1,620 | $50 | $84.4K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 1,540 | $50 | $77K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 2,900 | $20 | $60.8K |
| 81288 | The lab analyst performs the technical lab test involving promoter methylation analysis to detect changes for the mutL homolog 1, or MLH1 gene, also known as the colon cancer or nonpolyposis type 2… | 270 | $190 | $51.1K |
| 81272 | The lab analyst performs the technical lab test for a partial gene sequence analysis for the v–kit Hardy–Zuckerman 4 feline sarcoma viral oncogene homolog, or KIT, gene. The analysis does not analyze… | 80 | $320 | $26.8K |
Showing 1–10 of 103
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 103 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
103 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 1 | 10 | 880 | $530 | $835.6K |
| 88185 | 1 | 10 | 1,270 | $20 | $216.1K |
| 83521 | 4 | 10 | 100 | $20 | $152.9K |
| 81256 | 3 | 10 | 1,000 | $60 | $92.7K |
| 86003 | 26 | 30 | 640 | $10 | $89.2K |
| 86147 | 5 | 10 | 270 | $20 | $83K |
| 86235 | 29 | 40 | 160 | $20 | $70.1K |
| 83921 | 7 | 10 | 50 | $20 | $63.5K |
| 86146 | 5 | 10 | 170 | $20 | $56.3K |
| 86008 | 4 | 10 | 510 | $20 | $55.3K |
Showing 1–10 of 103
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.
198 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| U0003 | 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, making use of high… | 163,570 | $80 | $13.6M |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 25,970 | $420 | $10.9M |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 10,380 | $790 | $8.2M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 47,550 | $110 | $5.1M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 18,630 | $180 | $3.4M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 34,720 | $60 | $2.2M |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 7,630 | $220 | $1.7M |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 9,200 | $100 | $901.8K |
| 88262 | The analyst performs a chromosome analysis, a test that examines a person’s genetic material for abnormalities, counts 15 to 20 cells, and makes two karyotypes with banding, which are pictures of the… | 9,400 | $70 | $695.6K |
| 88230 | The lab analyst performs a procedure to grow a tissue culture for lymphocytes in a nonneoplastic disorder, typically using blood. Lymphocytes, a type of white blood cell, function as part of the… | 9,380 | $60 | $563K |
Showing 1–10 of 198
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
198 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 4 | 20 | 240 | $400 | $13.6M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 3 | 30 | 170 | $260 | $2.6M |
| U0003 | 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, making use of high… | 5 | 160 | 840 | $70 | $2.3M |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 1 | 10 | 680 | $480 | $1.9M |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 67 | 110 | 1,450 | $110 | $1.7M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 30 | 40 | 480 | $40 | $1.4M |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 47 | 80 | 420 | $30 | $1.2M |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 39 | 70 | 280 | $20 | $896.7K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 18 | 360 | 1,830 | $40 | $819.8K |
| 86480 | The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies. | 14 | 20 | 310 | $30 | $676.6K |
Showing 1–10 of 198
Other providers in the same ZIP code as Laboratory Corporation Of America Holdings, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Laboratory Corporation Of America Holdings | NC | Clinical Medical Laboratory | $3.5M | $281.4M |
| Laboratory Corporation Of America Holdings | NC | Clinical Medical Laboratory | $9.6M | $115.7M |
| Integrated Laboratory Solutions | NC | Clinical Medical Laboratory | $51.4K | $563.7K |
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