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NPI 1083249577 · Rochester, MN · Clinical Medical Laboratory
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Mayo Clinic is a clinical medical laboratory provider located in Rochester, Minnesota. This profile covers 524 Medicare and 301 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 | Mayo Clinic |
| Address | 200 1st St Sw |
| City | Rochester |
| State | MN |
| ZIP | 55905 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | March 5, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $15.2M |
| Medicare | $12.2M |
Payer mix and scale: this laboratory reports $12.2M in total Medicare revenue and $15.2M in total Medicaid revenue, so Medicaid is the larger single payer by absolute dollars while both payers are material to the business. The presence of large claim volumes on both Medicare and Medicaid indicates the operation functions at significant scale across payers rather than being effectively single‑payer.
Medicare revenue concentration and top drivers: the top three Medicare codes (36415, 81528, 85025) account for 24.8% of Medicare revenue, indicating meaningful concentration in a small set of high-volume services. Those top codes combine routine specimen collection (36415) and high-volume hematology testing (85025) with a higher‑priced stool DNA assay (81528), reflecting a mix of mass phlebotomy/processing and select higher‑margin molecular testing.
Medicaid revenue concentration and COVID/respiratory dependence: the top three Medicaid codes (U0003, U0005, 87636) account for 44.1% of Medicaid revenue, with U0003 alone generating $2.9M (29.5% of Medicaid revenue). This shows a strong reliance on SARS‑CoV‑2 and multiplex respiratory testing for Medicaid dollar volume, and those codes together create a large payer-specific concentration in pandemic/respiratory diagnostics.
Competitive standing — national for Medicare: multiple Medicare codes show the provider as a national outlier or leader. For example, 36415 ranks #61 of 86467 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 85025 ranks #54 of 32833 (100th percentile; extreme outlier), while proprietary test 0077U ranks #1 of 6 providers nationally (100th percentile; notably above typical national volume for this code), supporting a characterization of national prominence in both high-throughput routine testing and select proprietary assays.
Competitive standing — statewide for Medicaid: the provider is a major statewide player for COVID and several routine panels. U0003 ranks #6 of 274 in-state (98th percentile; notably above typical state volume for this code), 87636 ranks #2 of 56 in-state (98th percentile; extreme outlier, far above typical state volume for this code), and multiple routine panels (e.g., 80053, 84443, 82306) rank in the top few statewide positions, indicating dominant market share for certain test categories in Minnesota.
Service-line implications: the Medicaid and Medicare code mix shows a high-throughput clinical laboratory that performs massive volumes of routine chemistry and hematology (e.g., 80053, 80048, 85025, 83036, 82565) alongside specialized immunogenetics and proprietary diagnostics (e.g., 86832, 86833, 0077U). This combination suggests an operation structured for both bulk processing of standard panels and provision of complex, higher‑complexity tests that may be offered as referral or specialty services.
Revenue mix of volume vs. price: the provider bills extremely high claim counts for lower‑paid services (e.g., Medicare 36415 at 66K claims with $8 avg paid/claim; Medicare 85025 at 63.5K claims with $8 avg paid/claim) while also billing smaller volumes of high‑paid advanced assays (e.g., Medicare 81455 with 45 claims at $2737 avg paid/claim). That dual profile indicates operational capacity for both large-scale specimen throughput and support for specialist, high-reimbursement molecular/genomic testing.
Tenure and operational footprint: the NPI was enumerated on 2020-03-05 (~6 years ago), and despite the relatively recent enumeration date the provider reports very large volumes (examples include 66K Medicare claims for 36415 and 42.8K Medicaid claims for U0003), signaling rapid scale or aggregation of lab volume under this NPI. The combination of high volumes and multiple top‑ranked codes supports characterization as a sizable clinical lab operation rather than a small local facility.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
524 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 66,020 | $10 | $528.1K |
| 81528 | The lab analyst uses a stool sample and performs the technical lab tests for a fecal hemoglobin test and for real time amplification of 10 DNA markers. The lab analyst then carries out an algorithmic… | 1,050 | $500 | $525.9K |
| 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… | 63,500 | $10 | $508K |
| 86833 | The lab analyst performs a solid phase immunoassay using patient serum to identify the presence of specific antibodies to specific Class II human leukocyte antigens, or HLA, using a high–definition… | 1,380 | $310 | $423.5K |
| 86832 | The lab analyst performs a solid phase immunoassay using patient serum to identify the presence of specific antibodies to specific Class I human leukocyte antigens, or HLA, using a high–definition… | 1,380 | $310 | $423K |
| 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… | 21,810 | $20 | $370.8K |
| 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. | 33,830 | $10 | $338.3K |
| 83521 | The lab analyst performs a chemistry test to measure the level of each immunoglobulin light chain, kappa or lambda, in a serum specimen. A common lab method for this test is turbidimetry, which uses… | 14,380 | $20 | $244.5K |
| 0077U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report code 0077U for… | 5,800 | $40 | $243.6K |
| 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… | 6,040 | $40 | $229.4K |
Showing 1–10 of 524
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 524 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
524 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81528 | 2 | 10 | 1,460 | $500 | $727.3K |
| 81455 | 2 | 10 | 120 | $2,840 | $346.3K |
| 81450 | 2 | 10 | 370 | $740 | $276.5K |
| 88185 | 1 | 10 | 7,580 | $20 | $144.7K |
| 81206 | 2 | 10 | 290 | $160 | $98K |
| 81376 | 2 | 10 | 800 | $120 | $95.6K |
| 0077U | 1 | 10 | 910 | $40 | $95.1K |
| 81268 | 2 | 10 | 310 | $260 | $77.9K |
| 86833 | 1 | 10 | 30 | $310 | $68.2K |
| 86832 | 1 | 10 | 30 | $310 | $68K |
Showing 1–10 of 524
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.
301 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… | 42,760 | $70 | $2.9M |
| 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,… | 35,900 | $20 | $753.8K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 4,910 | $140 | $677.6K |
| 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… | 31,930 | $10 | $447K |
| 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… | 72,210 | $10 | $433.3K |
| 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… | 14,590 | $30 | $364.7K |
| 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. | 36,530 | $10 | $328.8K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 2,420 | $140 | $326.6K |
| 87507 | The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal… | 800 | $370 | $297.7K |
| 86832 | The lab analyst performs a solid phase immunoassay using patient serum to identify the presence of specific antibodies to specific Class I human leukocyte antigens, or HLA, using a high–definition… | 1,340 | $210 | $283.2K |
Showing 1–10 of 301
How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Minnesota median
301 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0482 | 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… | 8 | 10 | 2,200 | $120 | $1.3M |
| G0480 | 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… | 8 | 30 | 340 | $60 | $890.4K |
| 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. | 26 | 100 | 510 | $40 | $560.8K |
| 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… | 6 | 270 | 550 | $70 | $254.7K |
| 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… | 38 | 120 | 650 | $50 | $225.2K |
| 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… | 2 | 10 | 1,230 | $130 | $164.6K |
| 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)… | 22 | 30 | 110 | $120 | $144.5K |
| 82330 | The lab analyst measures this ionized form of calcium primarily on serum, blood, or a capillary sample. Providers use ionized calcium testing extensively during major surgeries where the importance… | 4 | 10 | 910 | $10 | $127.6K |
| 87507 | The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal… | 1 | 10 | 260 | $360 | $122.4K |
| 81376 | The lab analyst performs the technical lab test for low or intermediate resolution assessment of human leukocyte antigen genes, called HLA, for one Class II locus using molecular techniques. | 2 | 10 | 480 | $170 | $96.4K |
Showing 1–10 of 301
Other providers in the same ZIP code as Mayo Clinic, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Mayo Collaborative Services, Inc | MN | Clinical Medical Laboratory | $6.5M | $39.2M |
| Mayo Clinic | MN | Multi-Specialty Clinic/Center | $0 | $10.9M |
| Mayo Foundation For Medical Education & Research | MN | Durable Medical Equipment & Medical Supplies | $9.3K | $2.8M |
| Vidhu Kaushik | MN | Clinical Pathology/Laboratory Medicine Physician | $59.6K | $1.9M |
| Roberto Leon Ferre | MN | Medical Oncology Physician | $1.3M | $0 |
| Peter Noseworthy | MN | Cardiovascular Disease Physician | $1.1M | $0 |
| Daniel Childs | MN | Medical Oncology Physician | $1.1M | $0 |
| Robert Jacobson | MN | Pediatrics Physician | $975.6K | $0 |
| Brittany Siontis | MN | Medical Oncology Physician | $960.6K | $0 |
| Sani Kizilbash | MN | Medical Oncology Physician | $946.7K | $0 |
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