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NPI 1063734739 · Cleveland, OH · Clinical Medical Laboratory
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Cleveland Heartlab Inc is a clinical medical laboratory provider located in Cleveland, Ohio. This profile covers 170 Medicare and 56 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 | Cleveland Heartlab Inc |
| Address | 6701 Carnegie Ave |
| City | Cleveland |
| State | OH |
| ZIP | 44103 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 23, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $9.1M |
| Medicaid | $840K |
This entity is heavily Medicare-weighted: reported lifetime Medicare revenue is $9.1M versus $840K in Medicaid, so Medicare is the dominant payer by an order of magnitude and the primary revenue source for the business. The dollar gap indicates the operation functions largely in the Medicare market while still maintaining a measurable Medicaid presence.
The provider is a long-standing clinical laboratory: NPI was enumerated on 2010-02-23 (~16 years ago) and taxonomy is Clinical Medical Laboratory, consistent with an established reference-lab operation rather than a recent or transient billing entity. The tenure supports that the reported high volumes and specialized test mix reflect sustained service lines rather than a short-term billing spike.
The revenue-driving code mix signals a specialty cardiovascular and advanced biomarker testing focus: Medicare top codes include 82542 ($915.9K), 83698 ($902.2K), and 83876 ($684.6K) which map to column chromatography/mass spectrometry workups, Lp-PLA2, and myeloperoxidase testing respectively, and Medicaid top codes include 83704 ($140.9K) and 83698 ($110.3K). Together these line items show the lab provides mass-spectrometry and other high-complexity assays used for cardiovascular risk profiling and related hormonal/metabolic testing rather than only basic clinical panels.
Revenue concentration is meaningful on Medicare: the precomputed top 3 Medicare codes account for 34.7% of total Medicare revenue, with individual shares of 12.7% for 82542, 12.5% for 83698, and 9.5% for 83876. This concentration indicates that a relatively small set of specialized assays drives more than one-third of Medicare income, which is important for forecasting and payer negotiations.
On Medicaid the provider is even more concentrated around a few lipid/cardiac markers: the precomputed top 3 Medicaid codes account for 41.1% of Medicaid revenue, led by 83704 (17.3%, $140.9K), 83698 (13.6%, $110.3K) and 82172 (10.2%, $82.7K). Those three codes also place the lab among the top in-state performers for these assays, underscoring state-level reliance on this vendor for specialized lipid and apolipoprotein testing.
The provider is a nationally prominent volume leader for multiple specialized Medicare codes: 82542 ranks #1 of 128 providers nationally (100th percentile; extreme outlier), 83698 ranks #1 of 73 (100th percentile; extreme outlier), and 83876 ranks #2 of 41 (98th percentile; extreme outlier). These rankings indicate the lab is an outsized national player for advanced cardiovascular biomarker testing rather than a marginal participant.
Operationally the pattern reflects a high-throughput reference lab model: very large claim counts underline volume-driven service delivery (for example, 39.8K claims for 82542, 20K claims for 83698, and 33.6K claims for 80053) with modest average paid/claim amounts on many items, consistent with processing many specimens at scale. This mix of high claim counts and lower per-claim payments is typical for centralized labs serving wide referral networks.
The portfolio includes both specialized and routine testing: alongside the advanced biomarkers, the lab reports substantial Medicare revenue for broader panels and endocrine tests such as 80053 ($336.2K), 80061 ($275.5K), and 83036 ($109.6K), with many of those routine codes showing typical to notably above-typical national volume. That combination suggests the facility services both specialty cardiovascular testing and more general clinical laboratory needs for its referral base.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
170 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 82542 | The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using column chromatography and possibly mass spectrometry. | 39,820 | $20 | $915.9K |
| 83698 | The lab analyst measures the amount of lipoprotein associated phospholipase A2, called Lp PLA2, in the patient specimen. | 20,050 | $50 | $902.2K |
| 83876 | The lab analyst measures the amount of myeloperoxidase, an enzyme present in neutrophils, in the patient specimen. | 13,970 | $50 | $684.6K |
| 83704 | The lab analyst performs a test to measure the lipoprotein particle numbers and possibly lipoprotein particle subclasses in blood. | 15,400 | $30 | $508.3K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 33,620 | $10 | $336.2K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 11,340 | $30 | $328.7K |
| 82172 | The lab analyst performs apolipoprotein testing on components of lipoprotein complexes that contain a variety of high, low, and very–low density lipoproteins. The three most important of these… | 14,570 | $20 | $291.4K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 21,190 | $10 | $275.5K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 15,890 | $20 | $254.2K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 16,910 | $20 | $253.6K |
Showing 1–10 of 170
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 170 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.
56 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 83704 | The lab analyst performs a test to measure the lipoprotein particle numbers and possibly lipoprotein particle subclasses in blood. | 8,290 | $20 | $140.9K |
| 83698 | The lab analyst measures the amount of lipoprotein associated phospholipase A2, called Lp PLA2, in the patient specimen. | 6,490 | $20 | $110.3K |
| 82172 | The lab analyst performs apolipoprotein testing on components of lipoprotein complexes that contain a variety of high, low, and very–low density lipoproteins. The three most important of these… | 9,190 | $10 | $82.7K |
| 82542 | The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using column chromatography and possibly mass spectrometry. | 10,690 | $10 | $64.1K |
| 83695 | The lab analyst performs a test to measure the amount of lipoprotein a, typically in patient blood. | 8,670 | $10 | $60.7K |
| 86141 | The lab analyst performs the technical lab test to analyze the specimen, such as serum, for high sensitivity C reactive protein, hsCRP. | 7,950 | $10 | $55.6K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 3,970 | $10 | $51.5K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 10,080 | $10 | $50.4K |
| 83880 | The lab analyst measures the amount of natriuretic peptide, a hormone made by heart muscle cells, in the patient specimen. Blood levels of the hormone increase in patients with congestive heart… | 1,990 | $20 | $37.9K |
| 83876 | The lab analyst measures the amount of myeloperoxidase, an enzyme present in neutrophils, in the patient specimen. | 2,510 | $10 | $22.5K |
Showing 1–10 of 56
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
56 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 22 | 50 | 220 | $30 | $675.9K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 197 | 270 | 8,700 | $10 | $353.7K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 167 | 240 | 2,610 | $10 | $239.7K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 54 | 260 | 760 | $20 | $187.3K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 49 | 280 | 1,450 | $10 | $178.3K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 222 | 230 | 4,530 | $10 | $140.8K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 273 | 410 | 2,650 | $1 | $124.4K |
| 83698 | The lab analyst measures the amount of lipoprotein associated phospholipase A2, called Lp PLA2, in the patient specimen. | 1 | 10 | 5,160 | $20 | $105.8K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 101 | 210 | 860 | $10 | $77.1K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 109 | 250 | 570 | $10 | $72.3K |
Showing 1–10 of 56
Other providers in the same ZIP code as Cleveland Heartlab Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| The Centers For Families And Children | OH | Social Worker | $0 | $22.9M |
| Community Action Against Addiction | OH | Methadone Clinic | $89.4K | $13.6M |
| Northeast Ohio Neighborhood Health Services, Inc. | OH | Federally Qualified Health Center (FQHC) | $0 | $7.2M |
| Church Square Pharmacy Inc. | OH | Community/Retail Pharmacy | $63.9K | $120 |
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