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NPI 1164494142 · Brookfield, WI · Clinical Medical Laboratory
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Dermatopathology Of Wisconsin Sc is a clinical medical laboratory provider located in Brookfield, Wisconsin. This profile covers 9 Medicare and 5 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 | Dermatopathology Of Wisconsin Sc |
| Address | 12805 W Burleigh Rd |
| City | Brookfield |
| State | WI |
| ZIP | 53005 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 3, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1M |
| Medicaid | $304.1K |
DERMATOPATHOLOGY OF WISCONSIN SC is a Clinical Medical Laboratory whose billed services are concentrated in surgical pathology and ancillary immunohistochemistry/consultation work: the code mix is led by 88305 (surgical pathology level IV) with material contributions from consultation (88321) and immunohistochemistry stains (88341/88342), consistent with a high-volume histopathology and reference-read operation rather than a broad ambulatory clinic mix. The presence of both primary surgical pathology reads and multiple IHC codes indicates on-site slide interpretation plus ancillary testing capacity.
Medicare revenue is concentrated: the practice reports $1M in total Medicare revenue and its top 3 Medicare codes by revenue account for 87.7% of that Medicare revenue, with 88305 alone representing 74.0% of Medicare receipts. This concentration signals that a small set of high-intensity pathology services drive the majority of Medicare billing.
Medicaid revenue shows even higher concentration toward surgical pathology: total Medicaid revenue is $304.1K and the top 3 Medicaid codes account for 98.9% of Medicaid revenue, with 88305 contributing 94.2% of the provider's Medicaid receipts. Medicaid billing is therefore overwhelmingly dependent on the same surgical pathology service line that dominates Medicare.
The provider is materially larger on Medicare than Medicaid (Medicare $1M vs Medicaid $304.1K), making Medicare the primary payer relationship by scale for this entity; Medicaid is a smaller but similarly service-concentrated revenue source rather than an equal partner. This payer mix suggests contracting and operational priorities will be weighted toward Medicare-facing volumes and reimbursement dynamics.
On competitive standing for Medicare, the practice is an extreme national outlier for certain codes: 88305 ranks #99 of 14580 (99th percentile; extreme outlier) and 88321 ranks #10 of 2411 (100th percentile; extreme outlier), while some IHC codes such as 88341 and 88342 rank in the 97th percentile (typical, unremarkable volume for those codes). These rankings indicate the provider is a nationally prominent reporter for core surgical pathology and consult services, with unusually high national volumes on key codes.
In-state competitive positioning on Medicaid is strong for core surgical pathology but less exceptional than Medicare: 88305 ranks #24 of 194 in-state (88th percentile; typical, unremarkable volume for this code), indicating above-average but not extreme Medicaid market volume for that service. The provider appears to uniquely report 88321 in-state (rank #1 of 1, 0th percentile; no state peer volume comparison available), suggesting the practice may serve as a lone or unusual source of that consult code in Wisconsin but with no direct statewide peer comparison.
Operational implications of the code mix include a business model centered on processing and interpreting surgical specimens at scale (88305) plus providing consultative reads (88321) and on-site IHC that supports tumor/tissue workups (88341/88342). This mix is consistent with a reference pathology lab that accepts external cases and performs both diagnostic reads and ancillary testing, so capacity and margins will be highly sensitive to volumes in those specific service lines.
The practice has an established tenure (NPI enumerated 2006-02-03, ~20 years ago), which combined with highly concentrated revenue streams suggests an experienced operator with dependence on a narrow set of high-volume pathology services; this creates operational leverage when negotiating payer contracts but also operational exposure if reimbursement or referral patterns change for the dominant codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 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… | 17,810 | $40 | $748.1K |
| 88321 | A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received. | 1,040 | $70 | $72.5K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 1,150 | $60 | $65.6K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 910 | $70 | $60.3K |
| 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… | 510 | $70 | $35.9K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 710 | $20 | $17.1K |
| 88323 | A qualified provider, typically a pathologist, provides consultation and a report on referred material, such as a tissue block, and prepares and stains slides. A unit of service is the surgical case… | 100 | $80 | $8.1K |
| 88344 | The lab analyst applies a single multiplex antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 20 | $110 | $1.9K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 20 | $50 | $1.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 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.
5 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… | 9,630 | $30 | $289K |
| 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… | 370 | $20 | $8.2K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 570 | $10 | $6.2K |
| 88321 | A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received. | 80 | $30 | $2.2K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 40 | $20 | $1.1K |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 24 | 190 | 940 | $20 | $115.2K |
| 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… | 15 | 40 | 180 | $10 | $9.9K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 54 | 70 | 240 | $10 | $9.7K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 23 | 70 | 200 | $10 | $4.6K |
| 88321 | A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received. | 1 | 10 | 80 | $30 | $2.2K |
Other providers in the same ZIP code as Dermatopathology Of Wisconsin Sc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Community Care Health Plan, Inc | WI | Health Maintenance Organization | $0 | $63.1M |
| Linda Klotz | WI | Behavior Analyst | $0 | $2.9M |
| Alec H. Jaret, Dmd, PC | WI | Dentist | $0 | $2.4M |
| Heather Martyn | WI | Behavior Analyst | $0 | $2.4M |
| Samantha Gates | WI | Behavior Analyst | $0 | $2.2M |
| Holly Bruski | WI | Behavior Analyst | $0 | $1.9M |
| Brittany Naida | WI | Behavior Analyst | $0 | $1.7M |
| Thomas Kelley | WI | Periodontics | $0 | $1.7M |
| Hospice Preferred Choice, Inc | WI | Community Based Hospice Care Agency | $0 | $1.5M |
| Family Options Counseling, LLC | WI | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $1.3M |
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