Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or U.S. Virgin Islands for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to U.S. Virgin Islands only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. U.S. Virgin Islands (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Vi Pathology LLC (NPI 1134183791)

Key Findings

Field	Value
Entity Type	Organization
Organization	Vi Pathology LLC
Address	4093 Diamond Ruby
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	April 12, 2006

Payer Source	Total Paid
Medicaid	$65.1K
Medicare	$0

VI PATHOLOGY LLC reports no Medicare billing on file and $65.1K in lifetime Medicaid revenue, making its presence in this dataset effectively single-payer (Medicaid) rather than split between Medicare and Medicaid. The absence of Medicare activity indicates the provider’s identifiable billing footprint in the Medicare program is nil for the available period, so payer/contracting exposure and competitive comparisons should be evaluated primarily against Medicaid activity.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 79.2% of the provider’s total Medicaid revenue, with a single code, 88305, contributing $38.3K (58.7% of Medicaid revenue). That concentration means a small set of pathology services drive the majority of reported Medicaid dollars for this entity, which increases revenue sensitivity to utilization and reimbursement changes for those specific codes.

The code mix is consistent with a pathology practice focused on surgical specimen interpretation and basic lab testing: high-revenue interpretive codes include 88305 (1.9K claims, $20 avg paid/claim) and 88307 (40 claims, $85 avg paid/claim), both pathologist-level surgical pathology examinations, while 87426 (268 claims, $37 avg paid/claim) shows use of SARS–CoV–2 antigen/assay testing. This combination implies the entity provides both interpretive anatomic pathology services and some infectious-disease testing capacity rather than being solely a high-volume standalone phlebotomy site.

Operational throughput shows many low-unit-value routine tests: 85027 (1.7K claims, $2 avg paid/claim, $3.3K revenue), 85025 (1.5K claims, $2 avg paid/claim, $3K revenue), and 80053 (1.2K claims, $2 avg paid/claim, $2.5K revenue) together represent high claim volumes but modest revenue shares. These high-count/low-dollar lines indicate a high-volume, low-margin component to the practice (routine CBCs and basic metabolic panels) that supplements its higher-dollar interpretive pathology work.

State-level competitive standing is modest for most high-revenue codes: 88305 ranks #2 of 3 in-state at the 50th percentile (described in the file as typical, unremarkable volume), and 87426 ranks #3 of 6 at the 60th percentile (also typical). By contrast, 88307 is listed as #1 of 1 with a 0th percentile note (no state peer volume comparison available), making the provider the sole billed in-state reporter for that code in this dataset, but that role is small in dollar terms ($3.4K, 5.2% of Medicaid revenue).

Several codes in the file report claims with a $0 average paid/claim (for example 82948, 81003, 80048, 86904), which suggests portions of the provider’s claim lines are recorded with zero reimbursement in this dataset or are being reported in a bundled manner. Analysts should treat those line-items cautiously for revenue modeling because they do not contribute recorded Medicaid dollars here despite nontrivial claim counts for some codes.

There are a few code-level outliers in percentile/peer context that warrant note: 88312 is ranked #1 of 2 in-state (100th percentile) but is still a small revenue contributor ($1.9K, 2.9% of Medicaid revenue) and is described as typical, unremarkable volume; conversely, 88307’s sole-in-state status (no peer comparison) makes it unique in the file even though it generates only $3.4K. These labels indicate the provider can be a top or unique in-state reporter on specific niche pathology services while overall remaining a modest Medicaid revenue contributor.

The provider’s NPI was enumerated on 2006-04-12 (~20 years ago), indicating long tenure in the NPI registry. Despite this longevity, the measurable Medicaid billing footprint in the dataset is limited ($65.1K lifetime), implying established local presence but a relatively small Medicaid market share; payers should consider this when assessing network capacity in the U.S. Virgin Islands where local pathology capacity may be sparse.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

19 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…	1,910	$20	$38.3K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	270	$40	$9.9K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	40	$90	$3.4K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	1,670	$1	$3.3K
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…	1,510	$1	$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.	1,230	$1	$2.5K
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…	160	$10	$1.9K
86850	The lab analyst performs a screening test using patient blood to determine the presence of any antibodies to red blood cells, called RBCs, other than the A and B antigens.	560	$1	$1.7K
84702	The lab analyst performs the technical lab test to measure the amount of hCG, also known as beta hCG, in blood to confirm or monitor pregnancy, or to diagnose certain tumors of the testes or ovaries.	70	$10	$440
85610	Prothrombin time is most commonly measured using the blood plasma. Chemicals like calcium and tissue factor are added to the plasma sample and then the time is noted when the plasma clots. To analyze…	300	$1	$300

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.

Claims Volume vs. U.S. Virgin Islands Distribution

Vi Pathology LLC — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — U.S. Virgin Islands

Full comparison — all codes billed, vs. U.S. Virgin Islands median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	7	10	1,720	$40	$171.6K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	4	10	210	$40	$123K
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…	2	10	1,910	$60	$112.4K
87070	The lab analyst performs the technical lab steps to culture a specimen from any source except urine, blood, or stool. This service involves aerobic culture, which refers to the presence of oxygen.…	3	10	780	$100	$99.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	3	10	260	$120	$95.3K
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…	9	10	2,510	$10	$45.4K
82948	The clinician performs a test to measure the amount of glucose in a patient's blood using a reagent strip test method.	3	10	1,060	$20	$27.1K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	3	10	1,670	$10	$15.4K
87088	The lab analyst or microbiologist observes a urine culture with an unknown organism or organisms and makes a presumptive identification of each organism that needs identification.	6	10	220	$10	$13.3K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	7	10	860	$10	$12.9K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Croix Vision Center Inc	VI	Optometrist	$0	$3.6M
One Dental Practice LLC	VI	Dentist	$0	$3.2M
Governor Juan F. Luis Hospital & Medical Center	VI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3M
Js Therapies, LLC	VI	Occupational Therapist	$0	$2.9M
Healthquest, LLC.	VI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.4M
Department Of Health, Ems Stx	VI	Land Ambulance	$0	$2.2M
Lindsy Wagner LLC	VI	Clinical Social Worker	$0	$2.2M
Ophthalmology Consultants, PC	VI	Ophthalmology Physician	$0	$2.1M
Acute Alternative Medical Group	VI	Emergency Medical Services (Emergency Medicine) Physician	$0	$1.9M
Pediatric Care Center LLC	VI	Pediatrics Physician	$0	$1.7M

Vi Pathology LLC — Billing Profile & Reimbursement Data

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Vi Pathology LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References