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NPI 1184734246 · Des Moines, IA · Clinical Medical Laboratory
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Iowa Pathology Associates PC is a clinical medical laboratory provider located in Des Moines, Iowa. This profile covers 37 Medicare and 13 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 | Iowa Pathology Associates PC |
| Address | 1212 Pleasant St |
| City | Des Moines |
| State | IA |
| ZIP | 50309 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3M |
| Medicare | $898.8K |
This provider is a pathology-focused clinical laboratory with a long tenure: NPI enumerated 2006-08-30 (~20 years ago). Its lifetime payer scale is concentrated in Medicaid by dollar volume — Total Medicare revenue is $898.8K versus Total Medicaid revenue of $3M — indicating the business is primarily Medicaid-driven in absolute revenue terms.
Surgical pathology drives the practice: the single largest revenue source for both payers is 88305 (surgical pathology, level IV). On Medicare 88305 accounts for $515.3K (58.6% of this provider's Medicare revenue) with 13.6K claims, and on Medicaid 88305 accounts for $2.3M (77.7% of this provider's Medicaid revenue) with 30.2K claims, highlighting routine high-volume processing of surgical specimens.
Medicare revenue is highly concentrated: the precomputed top-three Medicare codes account for 71.5% of Total Medicare revenue, led by 88305 at 58.6%, followed by 88342 at 7.2% and 88360 at 5.7%. This concentration shows the provider’s Medicare business depends disproportionately on a small set of pathology interpretation and immunohistochemistry services.
Medicaid revenue is even more concentrated: the precomputed top-three Medicaid codes account for 92.0% of Total Medicaid revenue, dominated by 88305 (77.7%), with 88307 (11.1%) and 88141 (3.2%) completing the top three. The Medicaid mix emphasizes both higher-level surgical pathology (88305 and 88307) and cytology interpretation (88141), meaning most Medicaid dollars flow from a narrow set of case types.
Competitive standing on Medicare shows unusually high national volume for several core pathology codes: 88305 ranks #159 of 14580 providers nationally (99th percentile; extreme outlier), 88307 ranks #53 of 8511 (99th percentile; extreme outlier), and 88304 ranks #49 of 8796 (99th percentile; extreme outlier). Those rankings indicate this provider bills far above typical national volume for multiple major surgical pathology codes.
Competitive standing in-state for Medicaid is dominant for core services: 88305 ranks #2 of 94 providers in-state (99th percentile; extreme outlier), 88141 ranks #1 of 24 (100th percentile; extreme outlier), and 88304 ranks #1 of 37 (100th percentile; extreme outlier). These state-level ranks suggest the provider is a leading Medicaid pathology vendor in Iowa for both surgical pathology and cytology interpretation.
The code mix shows both professional interpretation and specialized ancillary testing: substantial billing for immunohistochemistry codes such as 88342 and 88360 alongside high-volume surgical pathology codes (88305, 88307) implies the operation provides pathologist reads plus associated IHC testing for tumor workups. Presence of cytopathology interpretation (88141) further signals an integrated service line covering gynecologic cytology as well as surgical specimens.
Operational and payer-risk implications follow from concentration: with 71.5% of Medicare revenue and 92.0% of Medicaid revenue coming from each payer's top three codes respectively, reimbursement or referral changes affecting 88305/88307/88141/88342 could materially impact financials. The very large claim volumes reported for 88305 (Medicare 13.6K claims; Medicaid 30.2K claims) amplify that exposure and suggest the provider’s business model is highly reliant on high-throughput surgical pathology processing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
37 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… | 13,560 | $40 | $515.3K |
| 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,… | 1,190 | $50 | $63.1K |
| 88360 | The lab analyst applies a 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, evaluates the… | 810 | $60 | $50K |
| 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… | 1,190 | $40 | $45.4K |
| 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… | 550 | $60 | $35.1K |
| 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… | 490 | $70 | $32.8K |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 140 | $160 | $21.8K |
| 84165 | The lab analyst performs the technical lab test to separate and quantitate components of serum protein in a process called serum protein electrophoresis, SPE, or SPEP. The electrophoretic… | 1,460 | $10 | $19K |
| 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… | 930 | $20 | $14K |
| 86334 | The lab analyst performs immunofixation electrophoresis, typically on the patient’s serum, to diagnose and or monitor monoclonal gammopathies or myeloma, a bone marrow tumor. | 800 | $10 | $10.4K |
Showing 1–10 of 37
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 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.
13 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… | 30,220 | $80 | $2.3M |
| 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… | 3,020 | $110 | $329.3K |
| 88141 | The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by… | 4,260 | $20 | $93.8K |
| 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… | 3,630 | $30 | $90.6K |
| 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,… | 1,510 | $60 | $83K |
| 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… | 650 | $70 | $42.8K |
| 86255 | The lab analyst performs an immunoassay test to screen a patient’s blood, typically serum, for an antibody to a noninfectious agent using a fluorescent method. As a screening test, results show only… | 350 | $30 | $8.8K |
| 88302 | The physician, typically a pathologist, performs a level II examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 170 | $40 | $6.2K |
| 84165 | The lab analyst performs the technical lab test to separate and quantitate components of serum protein in a process called serum protein electrophoresis, SPE, or SPEP. The electrophoretic… | 110 | $20 | $1.9K |
| 86256 | The lab analyst performs a fluorescent immunoassay to titer the amount of antibody to a noninfectious agent in a patient’s blood, typically serum. | 100 | $20 | $1.7K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Iowa providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Iowa median
13 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… | 2 | 90 | 740 | $60 | $155.6K |
| 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… | 6 | 20 | 130 | $80 | $107.3K |
| 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,… | 4 | 30 | 140 | $30 | $18.9K |
| 86255 | The lab analyst performs an immunoassay test to screen a patient’s blood, typically serum, for an antibody to a noninfectious agent using a fluorescent method. As a screening test, results show only… | 4 | 10 | 470 | $20 | $15.7K |
| 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… | 2 | 10 | 50 | $50 | $13K |
| 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,… | 2 | 10 | 30 | $30 | $10.9K |
| 88141 | The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by… | 1 | 20 | 170 | $20 | $10.5K |
| 84165 | The lab analyst performs the technical lab test to separate and quantitate components of serum protein in a process called serum protein electrophoresis, SPE, or SPEP. The electrophoretic… | 9 | 10 | 140 | $10 | $8.7K |
| 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… | 1 | 40 | 100 | $20 | $8.2K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 6 | 10 | 120 | $20 | $6K |
Showing 1–10 of 13
Other providers in the same ZIP code as Iowa Pathology Associates PC, ranked by combined Medicare and Medicaid revenue.
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