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NPI 1043282841 · White Plains, NY · Clinical Medical Laboratory
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Ameripath New York LLC is a clinical medical laboratory provider located in White Plains, New York. This profile covers 16 Medicare and 13 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 | Ameripath New York LLC |
| Address | 1133 Westchester Ave Ste 331 |
| City | White Plains |
| State | NY |
| ZIP | 10604 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.2M |
| Medicaid | $4.9M |
The provider’s code mix and taxonomy (Clinical Medical Laboratory) indicate a core surgical pathology operation that also performs a range of ancillary specialty stains. High-revenue CPT codes such as 88305 and 88304 are primary surgical pathology examinations, while codes like 88312, 88341, 88342, 88350, and 88365 reflect extensive use of special stains, immunohistochemistry, and in situ hybridization; together these codes describe a laboratory that handles both high-volume specimen accessioning and higher-complexity diagnostic testing.
Medicare billing is highly concentrated: the precomputed top three Medicare codes (88305, 88312, 88304) account for 91.2% of the provider’s Medicare revenue, driven primarily by 88305 at $5.2M which alone represents 83.5% of Medicare receipts. This concentration means the provider’s Medicare performance is heavily dependent on surgical pathology case volume and reimbursement for that single core service.
Medicaid billing shows a similar concentration pattern: the precomputed top three Medicaid codes (88305, 88312, 88304) make up 92.7% of Medicaid revenue, with 88305 contributing $3.2M (66.9% of Medicaid revenue). The combination of large absolute Medicaid dollars and heavy reliance on the same three codes suggests the provider plays a central role in state-level surgical pathology processing.
The provider’s payer mix is not single-payer: lifetime Medicare revenue is $6.2M while lifetime Medicaid revenue is $4.9M, so Medicare is the larger single source but Medicaid represents a substantial portion of total public-payer volume. Analysts should treat this entity as a dual-payer clinical lab with meaningful exposure to both Medicare and Medicaid reimbursement policies and volumes.
Competitive standing for Medicare surgical pathology is dominant nationally: 88305 ranks #7 of 14580 providers (100th percentile; extreme outlier) and 88304 ranks #2 of 8796 providers (100th percentile; extreme outlier), while 88312 ranks #62 of 6966 (99th percentile; notably above typical national volume). Those high ranks and outlier labels indicate this provider processes far more surgical pathology cases than typical peers on a national scale.
State-level competitive standing for Medicaid mirrors the national pattern: 88305 ranks #1 of 642 in-state (100th percentile; extreme outlier) and 88304 ranks #1 of 257 in-state (100th percentile; extreme outlier), with 88312 at #8 of 261 (97th percentile; extreme outlier). This provider is effectively a top in-state destination for surgical pathology and related special-stain services based on reported Medicaid volumes.
Ancillary and higher-complexity tests (immunohistochemistry and in situ hybridization) are present but contribute smaller shares of revenue: codes such as 88341, 88342, 88350, 88365, and 88364 appear across both payers with measurable revenue and mostly above-typical ranks, indicating capability and regular use of these techniques without matching the dominant revenue contribution of primary surgical pathology codes. This pattern suggests the lab bundles high-volume routine pathology with a steady stream of specialty testing rather than relying on specialty tests as primary revenue drivers.
The provider has long tenure on Medicare/Medicaid rolls, with NPI enumeration on 2006-02-06 (~20 years ago), which together with the extreme-outlier volumes and top in-state/national ranks suggests an established referral footprint and an operational role as a central pathology processing site for its region. For payers and competitors, that combination of longevity plus concentrated high-volume coding signals a stable, entrenched service line to account for in network strategy or utilization reviews.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 84,150 | $60 | $5.2M |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 2,680 | $100 | $270.2K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 5,430 | $40 | $206.2K |
| 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… | 2,060 | $80 | $160.8K |
| 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,… | 1,730 | $90 | $153.7K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 1,320 | $100 | $136.2K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 450 | $100 | $47.2K |
| 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… | 110 | $150 | $16.4K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 190 | $70 | $13.9K |
| 88364 | The lab analyst applies an additional in situ hybridization single probe stain on a slide or slides prepared from the same patient specimen as the initial probe stain, such as tumor tissue. Then a… | 110 | $120 | $12.3K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 79,210 | $40 | $3.2M |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 13,690 | $50 | $698.3K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 21,290 | $30 | $553.6K |
| 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,… | 3,400 | $50 | $153K |
| 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… | 1,050 | $90 | $90.1K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 1,250 | $40 | $47.4K |
| 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… | 240 | $110 | $26.8K |
| 88364 | The lab analyst applies an additional in situ hybridization single probe stain on a slide or slides prepared from the same patient specimen as the initial probe stain, such as tumor tissue. Then a… | 320 | $70 | $21.9K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 230 | $40 | $9.2K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 240 | $30 | $6.8K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 1 | 640 | 1,080 | $60 | $251.5K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 8 | 260 | 310 | $80 | $112.4K |
| 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,… | 35 | 340 | 510 | $50 | $80K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 65 | 270 | 230 | $60 | $75.2K |
| 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… | 28 | 150 | 200 | $70 | $47.9K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1 | 260 | 450 | $20 | $28.7K |
| 88321 | A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received. | 15 | 20 | 110 | $70 | $18.6K |
| 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… | 4 | 10 | 110 | $50 | $13.4K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 3 | 10 | 100 | $40 | $8.5K |
| 88364 | The lab analyst applies an additional in situ hybridization single probe stain on a slide or slides prepared from the same patient specimen as the initial probe stain, such as tumor tissue. Then a… | 1 | 10 | 110 | $70 | $8.3K |
Showing 1–10 of 13
Other providers in the same ZIP code as Ameripath New York LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Unlimited Care, Inc. | NY | Home Health Agency | $0 | $213.7M |
| Maxim Of New York, LLC | NY | Home Health Agency | $0 | $36.5M |
| Cairo Diagnostics,llc | NY | Clinical Medical Laboratory | $2.8M | $299.5K |
| Matthew Weissler | NY | Hematology & Oncology Physician | $1.7M | $90 |
| Young Oh | NY | Orthopaedic Surgery Physician | $443.2K | $7.4K |
| Bryan Blair | NY | Urology Physician | $405.8K | $110 |
| Stephen Andrus | NY | Physical Medicine & Rehabilitation Physician | $359K | $340 |
| Judd Boczko | NY | Urology Physician | $355.9K | $0 |
| Adnan Hasanovic | NY | Anatomic Pathology & Clinical Pathology Physician | $197.4K | $135.1K |
| Richard Weinstein | NY | Sports Medicine (Orthopaedic Surgery) Physician | $317.1K | $250 |
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