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NPI 1144321951 · Lexington, KY · Clinical Medical Laboratory
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New Lexington Clinic, Psc is a clinical medical laboratory provider located in Lexington, Kentucky. This profile covers 179 Medicare and 83 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 | New Lexington Clinic, Psc |
| Address | 1221 S Broadway |
| City | Lexington |
| State | KY |
| ZIP | 40504 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.8M |
| Medicaid | $1.1M |
NEW LEXINGTON CLINIC, PSC operates as a Clinical Medical Laboratory based on its taxonomy and the code mix reported: high-volume specimen collection (36415), routine chemistry panels (80053, 80061, 80048), hematology (85025), endocrine testing (84443, 84439, 83970), vitamin and nutrient assays (82306, 82607, 82746), culture and sensitivity work (87086, 87186, 87077), and discrete pathology services (88305, G0416). The presence of both high-volume screening/panel codes and pathology codes indicates it provides both routine outpatient diagnostic testing and some anatomic pathology or specialized confirmatory services rather than only point-of-care screening.
Top revenue concentration on Medicare is meaningful: the top 3 Medicare codes by revenue account for 33.7% of this provider's total Medicare revenue, led by 36415 ($203.1K, 14.5% of Medicare revenue), 80053 ($146.8K, 10.5%) and 84443 ($123.7K, 8.8%). This concentration shows that routine phlebotomy and core lab panels drive a large share of Medicare revenue for the practice and should be focal points for utilization or network negotiations.
On the Medicaid side the top 3 codes by revenue account for 39.3% of this provider's total Medicaid revenue, with 80053 ($136.8K, 14.4%), 84443 ($135.2K, 14.3%) and 85025 ($100K, 10.6%) as the leading contributors. That profile indicates an even greater reliance on a small set of routine chemistry and hematology services for Medicaid reimbursement, suggesting payer-specific volume sensitivity in those panels.
The provider maintains a mixed payer footprint: lifetime Medicare revenue is $1.8M while lifetime Medicaid revenue is $1.1M, so Medicare represents the larger single source but Medicaid is a substantial portion of overall billing. This dual-payer scale implies the clinic serves both older adults and Medicaid populations in its region and will be affected by policy or network changes across both programs.
National competitive standing on key Medicare codes is strong for routine specimen collection and common panels: 36415 is ranked #107 of 86467 providers nationally (100th percentile; notably above typical national volume for this code), and common lab panels 80053 and 84443 both sit in the 99th percentile nationally for volume. Those ranks indicate the clinic is a major national-volume performer for phlebotomy and high-frequency outpatient lab tests, not just a low-volume local provider.
State-level competitive positioning for Medicaid is mixed: 84443 ranks #36 of 178 in-state (80th percentile) and 85025 ranks #85 of 310 (73th percentile), showing above-typical in-state volume for thyroid and CBC testing, while 80053 is mid-ranked at #94 of 195 (52th percentile). In short, the clinic is a solid regional player for several diagnostic tests but not uniformly dominant across all Medicaid panels in Kentucky.
Beyond routine panels, the clinic reports meaningful revenue from higher-complexity or specialty tests that support broader service capability: Medicare surgical pathology 88305 ($88.4K) and G0416 prostate biopsy pathology ($40.9K) appear on the top Medicare list, and definitive drug testing G0480 ($58.1K Medicare; $17.4K Medicaid) is present on both payers. Those items indicate capacity for anatomic pathology and definitive toxicology workflows in addition to high-throughput chemistry testing.
The provider exhibits operational longevity that supports stable service lines: NPI enumerated 2006-09-26 (~20 years ago). Recent episodic testing volumes such as U0003 (COVID PCR) appear at moderate levels on both payers (Medicare: 320 claims, $23K revenue; Medicaid: 682 claims, $38.9K revenue), consistent with an established outpatient lab that scaled routine and public-health testing during recent years.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
179 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. | 25,390 | $10 | $203.1K |
| 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. | 14,680 | $10 | $146.8K |
| 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… | 7,730 | $20 | $123.7K |
| 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. | 9,360 | $10 | $121.6K |
| 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… | 13,680 | $10 | $109.5K |
| 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… | 2,010 | $40 | $88.4K |
| 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… | 2,760 | $30 | $80K |
| 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… | 520 | $110 | $58.1K |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 1,160 | $40 | $46.4K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 2,730 | $20 | $41K |
Showing 1–10 of 179
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 179 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.
83 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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. | 19,540 | $10 | $136.8K |
| 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… | 12,290 | $10 | $135.2K |
| 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… | 20,000 | $10 | $100K |
| 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. | 11,850 | $10 | $94.8K |
| 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… | 4,250 | $20 | $80.7K |
| 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… | 680 | $60 | $38.9K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 7,480 | $10 | $37.4K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 3,770 | $10 | $33.9K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 1,450 | $20 | $33.4K |
| 82746 | The lab analyst measures the folic acid level in serum to determine if there is a deficiency. Folic acid deficiency is attributed to many conditions such as malabsorption, Crohn’s disease, celiac… | 2,590 | $10 | $23.3K |
Showing 1–10 of 83
How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kentucky median
83 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 252 | 340 | 2,700 | $40 | $673.3K |
| 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… | 101 | 140 | 2,000 | $60 | $639.8K |
| 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… | 73 | 110 | 2,280 | $50 | $552.6K |
| 81513 | The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and… | 6 | 10 | 340 | $100 | $549.4K |
| 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. | 94 | 200 | 16,730 | $10 | $365.9K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 8 | 20 | 810 | $20 | $225K |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 48 | 80 | 480 | $50 | $177.8K |
| 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,… | 60 | 70 | 2,800 | $10 | $176.1K |
| 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… | 85 | 310 | 3,500 | $10 | $149.9K |
| 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… | 47 | 80 | 680 | $40 | $145.8K |
Showing 1–10 of 83
Other providers in the same ZIP code as New Lexington Clinic, Psc, ranked by combined Medicare and Medicaid revenue.
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