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NPI 1194027953 · Cheyenne, WY · Clinical Medical Laboratory
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Regional West Medical Center is a clinical medical laboratory provider located in Cheyenne, Wyoming. This profile covers 95 Medicare and 14 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 | Regional West Medical Center |
| Address | 1331 Prairie Ave |
| City | Cheyenne |
| State | WY |
| ZIP | 82009 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 30, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $256.1K |
| Medicaid | $62.6K |
This entity reports Lifetime Medicare revenue of $256.1K and Lifetime Medicaid revenue of $62.6K, so Medicare is the larger payer by scale for this provider; both payers are active on file rather than presenting a single-payer profile. The presence of meaningful billing across both programs supports mixed payer operations, with Medicare representing the dominant revenue source in absolute dollars.
The provider’s NPI was enumerated on 2010-11-30 (~16 years ago), indicating a long-standing enrollment and an established billing history in Medicare and Medicaid. That tenure is consistent with an ongoing clinical laboratory operation rather than a recent or transient billing pattern.
Medicare top codes (80053, 36415, 80061) point to a core outpatient clinical laboratory and specimen-collection workflow: 80053 (CMP) and 80061 (lipid panel) are routine chemistry panels while 36415 reflects high-volume phlebotomy. Those three Medicare codes account for 43.3% of the provider’s total Medicare revenue, so routine chemistry/hematology panels plus specimen collection drive a large share of Medicare receipts.
Medicaid billing is similarly concentrated in core panels: 80053 (CMP), 85025 (CBC), and 84443 (TSH) together account for 59.0% of this provider’s total Medicaid revenue, indicating Medicaid volumes are especially driven by general metabolic, hematology, and thyroid testing. The Medicaid top codes and their payment levels (for example 80053: 3K claims, $5 avg paid/claim, $15K revenue) suggest heavy utilization of basic diagnostic panels among the provider’s Medicaid population.
On national Medicare competitiveness the provider ranks in high percentiles for many routine tests — for example 80053 ranks #397 of 26416 providers (99th percentile), 80061 ranks #360 of 21671 (98th percentile), and 36415 ranks #420 of 86467 (100th percentile). These high national ranks place the provider among higher-volume peers for routine chemistry and phlebotomy, though the listed volume descriptors often label these volumes as "typical, unremarkable" for the code, implying the provider is a high-volume, but not atypical, contributor to routine testing nationally.
Within Wyoming Medicaid the provider appears to be a leading in-state laboratory for several tests: 80061, 83036, and 84443 each rank #1 in-state at the 100th percentile, with 80061 described as an "extreme outlier, far above typical state volume" and 84443 as "notably above typical state volume." By contrast 80053 and 85025 rank #5 of 31 in-state (87th percentile), indicating strong but not exclusive market share across standard panels.
The provider’s Medicare portfolio includes non-routine infectious-disease testing at visible volumes: 87428 (SARS/flu antigen panel) appears on the Medicare top-25 with $5.7K revenue and is ranked #259 of 10591 providers (98th percentile) with the descriptor "notably above typical national volume," signaling capacity for respiratory pathogen testing beyond routine chemistry. Additional specialized tests such as 87556 (TB nucleic acid) and 87536 (HIV viral load) are present at lower Medicare revenue levels, consistent with a lab that supports some infectious-disease and specialized molecular testing.
Revenue concentration across a few codes is material and asymmetric between payers: the top 3 Medicare codes account for 43.3% of Medicare revenue while the top 3 Medicaid codes account for 59.0% of Medicaid revenue. This concentration means reimbursement changes or utilization shifts for a small set of panels (CMP, CBC, TSH, lipid, A1C and venipuncture) would disproportionately affect the provider’s overall payer revenue, with Medicaid exposure appearing more concentrated than Medicare.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
95 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. | 3,530 | $10 | $35.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 3,970 | $10 | $31.8K |
| 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. | 2,140 | $10 | $27.9K |
| 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… | 3,200 | $10 | $25.6K |
| 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… | 1,460 | $20 | $23.4K |
| 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).… | 1,030 | $10 | $10.3K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 940 | $10 | $8.4K |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 130 | $50 | $5.7K |
| 84481 | The lab analyst performs a test to measure free T3 in patient blood. | 330 | $20 | $5.6K |
| 87556 | The lab analyst performs a test for Mycobacterium tuberculosis using amplified nucleic acid probe technique. Mycobacteria tuberculosis are sometimes called acid fast bacteria because of the special… | 120 | $40 | $4.7K |
Showing 1–10 of 95
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 95 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.
14 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. | 3,000 | $10 | $15K |
| 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… | 2,640 | $1 | $10.5K |
| 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… | 1,190 | $10 | $9.5K |
| 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. | 1,250 | $10 | $7.5K |
| 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).… | 1,040 | $1 | $4.1K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 3,830 | $1 | $3.8K |
| 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… | 70 | $50 | $3.7K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 610 | $10 | $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… | 30 | $20 | $660 |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 10 | $50 | $610 |
Showing 1–10 of 14
How this provider's Medicaid billing volume and revenue compare to other Wyoming providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wyoming median
14 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 13 | 10 | 90 | $30 | $8.9K |
| 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… | 1 | 10 | 70 | $50 | $3.7K |
| 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. | 5 | 30 | 200 | $1 | $2.3K |
| 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… | 1 | 10 | 80 | $10 | $1.7K |
| 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… | 5 | 30 | 430 | $1 | $1.5K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 1 | 10 | 130 | $10 | $1.4K |
| 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. | 1 | 10 | 30 | $10 | $1.1K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 3 | 50 | 140 | $1 | $820 |
| 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).… | 1 | 10 | 40 | $1 | $630 |
| 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… | 3 | 10 | 30 | $10 | $390 |
Showing 1–10 of 14
Other providers in the same ZIP code as Regional West Medical Center, ranked by combined Medicare and Medicaid revenue.
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