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NPI 1073591822 · Asheville, NC · Clinical Medical Laboratory
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Genova Diagnostics Inc is a clinical medical laboratory provider located in Asheville, North Carolina. This profile covers 70 Medicare and 37 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 | Genova Diagnostics Inc |
| Address | 63 Zillicoa St |
| City | Asheville |
| State | NC |
| ZIP | 28801 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | January 3, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.8M |
| Medicaid | $33.9K |
GENOVA DIAGNOSTICS INC is a clinical medical laboratory enumerated on 2006-01-03 (~20 years ago) and licensed in Asheville, NC. Its billed Medicare volume dominates its public payer mix with total Medicare revenue of $3.8M versus total Medicaid revenue of $33.9K, indicating Medicare is the principal commercial engine for this entity.
Revenue concentration on Medicare is material: the provider’s top three Medicare codes account for 29.1% of its Medicare revenue, led by 82542 ($348.6K), 82715 ($337.4K), and 87505 ($163.8K). Those codes together point to a revenue-driving mix that includes mass‑spectrometry/chemistry work (82542), fecal fat analysis (82715), and multiplex nucleic acid pathogen testing (87505).
The code mix across both payers signals specialization in gastrointestinal diagnostics, metabolic/toxicology assays, and complex biochemical panels. High-volume stool and GI-related codes include 87046 (aerobic stool culture), 83993 (fecal calprotectin), 82274 (FIT), and 91065 (hydrogen/methane breath test), while toxicology/heavy‑metal and metabolic testing is evident in codes such as 82300 (cadmium), 83825 (mercury), 82139 (amino acid panels) and others, indicating a broad portfolio of specialized assays rather than routine point-of-care testing.
On national competitive standing for Medicare, the practice is a high-volume specialist for many individual assays: examples include 82715 (ranks #1 of 2, 100th percentile — listed as typical, unremarkable volume for that code), 87505 (ranks #2 of 69, 99th percentile and labeled an extreme outlier), and 87046 (ranks #1 of 179, 100th percentile and labeled an extreme outlier). These rankings show the provider is at or near the top of national peers for multiple specialized tests, consistent with a centralized reference-lab role for those procedures.
Medicaid activity is small and relatively concentrated: the top three Medicaid codes account for 48.1% of Medicaid revenue, with U0003 ($7.3K), 82542 ($5.6K), and 82507 ($3K) as the largest contributors. In-state rank data show modest market presence for Medicaid — for example U0003 ranks #125 of 158 in-state (21st percentile) while 82542 ranks #3 of 7 in-state (67th percentile) — indicating the lab’s Medicaid footprint is limited and not dominant statewide.
The disparity in scale between payers ($3.8M Medicare vs $33.9K Medicaid) implies the provider operates effectively as a Medicare-focused reference laboratory with only marginal Medicaid activity. Medicaid revenue is both small in absolute terms and concentrated, so payers should treat Medicaid patterns as a secondary lens when profiling this entity.
Multiple individual codes are explicitly labeled as statistical outliers or notably above typical volume nationally, reinforcing the picture of a specialized, high-throughput lab for select tests. Examples include 87505 (extreme outlier), 87046 (extreme outlier), 82300 (100th percentile, extreme outlier), and several other tests with 99–100th percentile ranks; this pattern suggests the provider processes high volumes for niche assays and may serve a broad referral network beyond local clinical ordering.
For payer and network strategy, the combination of concentrated Medicare revenue (top 3 = 29.1%) and national high ranks on specialized assays highlights both an opportunity and a monitoring priority: GENOVA DIAGNOSTICS should be considered a key supplier for complex GI, metabolic, and toxicology testing in Medicare populations, and utilization of its top codes warrants tracking against clinical expectations and regional referral patterns given the lab’s outsized presence on selected procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
70 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. | 14,530 | $20 | $348.6K |
| 82715 | The lab analyst measures and differentiates the fecal fat to assist the clinician in determining the origin of the steatorrhea. Defining the quantity and composition of the fecal fats as being… | 15,340 | $20 | $337.4K |
| 87505 | The lab analyst performs a test to detect three to five types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal… | 1,300 | $130 | $163.8K |
| 82507 | The lab analyst measures the amount of citrate in a patient specimen. Citrate is the conjugate base of citric acid. | 5,180 | $30 | $139.7K |
| 87046 | The lab analyst performs an aerobic bacterial stool culture, isolates possible pathogens, and presumptively identifies any pathogens other than Salmonella or Shigella. | 15,460 | $10 | $139.1K |
| 82653 | Code 82653 describes a chemistry test to measure the level of pancreatic elastase (EL–1) in a fecal specimen. A common lab method for this test is enzyme–linked immunosorbent assay (ELISA). Levels of… | 5,080 | $20 | $116.8K |
| 82300 | The lab analyst measures this element, typically in a blood sample when acute intoxication is expected or in a 24 hour urine specimen if the provider suspects chronic exposure to cadmium. Cadmium is… | 5,040 | $20 | $116K |
| 83150 | The lab analyst measures the level of homovanillic acid, or HVA, typically in a urine specimen. HVA is the end product of the neurotransmitter dopamine’s metabolism and a metabolite of the hormone… | 5,180 | $20 | $113.9K |
| 83785 | The lab analyst measures the amount of manganese, which is an essential nutrient, in the patient specimen. | 4,260 | $30 | $110.9K |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 21,940 | $10 | $109.7K |
Showing 1–10 of 70
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 70 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
70 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 82715 | 1 | 10 | 15,340 | $20 | $345K |
| 82653 | 2 | 10 | 5,080 | $20 | $163.9K |
| 83993 | 2 | 10 | 2,830 | $20 | $120.4K |
| 82542 | 1 | 10 | 230 | $20 | $93.9K |
| 86003 | 3 | 30 | 640 | $10 | $89.2K |
| 87046 | 1 | 10 | 6,390 | $10 | $65.4K |
| 86364 | 2 | 10 | 950 | $10 | $63.6K |
| 82507 | 1 | 10 | 1,610 | $30 | $63.1K |
| 82300 | 1 | 10 | 2,670 | $20 | $59.8K |
| 83785 | 1 | 10 | 2,260 | $30 | $59K |
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Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
37 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… | 140 | $50 | $7.3K |
| 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. | 930 | $10 | $5.6K |
| 82507 | The lab analyst measures the amount of citrate in a patient specimen. Citrate is the conjugate base of citric acid. | 180 | $20 | $3K |
| 83150 | The lab analyst measures the level of homovanillic acid, or HVA, typically in a urine specimen. HVA is the end product of the neurotransmitter dopamine’s metabolism and a metabolite of the hormone… | 180 | $10 | $2.2K |
| 83921 | The lab analyst measures the single organic acid analyte ordered, which may be any one of the more than 60 identified organic acid analytes. The specimen type may be serum, plasma, urine, amniotic… | 450 | $1 | $1.8K |
| 84585 | The lab analyst performs a test to measure the amount of vanillylmandelic acid, also known as VMA, in patient urine. | 190 | $10 | $1.7K |
| 82139 | The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the… | 150 | $10 | $1.5K |
| 83497 | The lab analyst measures the amount of 5 hydroxyindolacetic acid, typically in a 24 hour urine specimen. Clinicians use this testing primarily for the determination of carcinoid tumors or syndrome. | 180 | $10 | $1.4K |
| 84311 | The lab analyst performs a test by spectrophotometry to measure an analyte not elsewhere specified in another code. | 690 | $1 | $1.4K |
| 83993 | The lab analyst performs the technical lab test on a small amount of stool sample to measure the amount of calprotectin, typically using an enzyme linked immunosorbent assay, or ELISA, test… | 40 | $30 | $1.2K |
Showing 1–10 of 37
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
37 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 125 | 160 | 840 | $70 | $2.3M |
| U0005 | 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, cdc or non-cdc,… | 131 | 130 | 890 | $20 | $259.7K |
| 83993 | The lab analyst performs the technical lab test on a small amount of stool sample to measure the amount of calprotectin, typically using an enzyme linked immunosorbent assay, or ELISA, test… | 9 | 10 | 310 | $10 | $119K |
| 82274 | The lab analyst uses an immunoassay method to perform a test for hidden blood in a fecal specimen that the patient collects from three consecutive bowel movements or that the clinician acquires… | 11 | 10 | 480 | $10 | $102.9K |
| 82784 | The lab analyst performs the technical lab test to analyze the concentration of a particular gamma globulin in the specimen. The analyst may test for immunoglobulin A, immunoglobulin D,… | 27 | 30 | 570 | $10 | $88.1K |
| 82653 | Code 82653 describes a chemistry test to measure the level of pancreatic elastase (EL–1) in a fecal specimen. A common lab method for this test is enzyme–linked immunosorbent assay (ELISA). Levels of… | 4 | 10 | 1,350 | $10 | $81.1K |
| 83520 | The lab analyst measures the analyte, which is not an infectious agent antibody or infectious agent antigen, by immunoassay. Use 83520 for procedures that have no specific code assigned for the… | 15 | 20 | 350 | $10 | $65.5K |
| 87209 | The lab analyst performs and evaluates a complex special stain from a primary source specimen, such as stool, to look for parasite eggs, or ova, and parasites, which are organisms that live in or on… | 11 | 10 | 1,360 | $10 | $57.2K |
| 83655 | The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure. | 207 | 220 | 240 | $10 | $50.1K |
| 82139 | The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the… | 3 | 10 | 410 | $10 | $43.8K |
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Other providers in the same ZIP code as Genova Diagnostics Inc, ranked by combined Medicare and Medicaid revenue.
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