Loading...
NPI 1285621631 · Jacksonville, FL · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Mayo Clinic Jacksonville is a clinical medical laboratory provider located in Jacksonville, Florida. This profile covers 467 Medicare and 69 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 | Mayo Clinic Jacksonville |
| Address | 4500 San Pablo Rd S |
| City | Jacksonville |
| State | FL |
| ZIP | 32224 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 30, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $9.3M |
| Medicaid | $105.3K |
MAYO CLINIC JACKSONVILLE is overwhelmingly Medicare‑driven: the provider’s lifetime Medicare revenue is $9.3M versus Medicaid revenue of $105.3K, indicating Medicare is the primary payer by scale and the provider operates largely in the fee‑for‑service Medicare market rather than Medicaid. This imbalance suggests contracting, resource allocation, and capacity are oriented toward Medicare referrals and the types of tests Medicare covers.
Revenue concentration differs sharply by payer: the top 3 Medicare codes (80053, 88305, 85025) account for 26.4% of total Medicare revenue, showing a moderate concentration in a small set of high‑volume lab services, while the top 3 Medicaid codes (U0003, 80053, 87497) account for 67.0% of total Medicaid revenue, indicating Medicaid receipts are highly concentrated in a few services. For Medicaid this concentration is driven by COVID PCR (U0003) and routine panels billed at low per‑claim rates, whereas Medicare concentration reflects higher‑value pathology and routine lab volume.
The code mix shows a dual operating model: very high‑volume routine clinical chemistry and hematology (80053, 85025, 80048, 84443, 82306, 83036) combined with specialty and reference services (88305 surgical pathology, 86832/86833 HLA testing, 81455 genomic panel, 81528 stool DNA screening). This pattern is consistent with a large, hospital‑affiliated or reference clinical medical laboratory that processes both common outpatient panels and specialized molecular/immunologic tests for complex patients.
National competitive standing in Medicare is strong for many routine tests: 80053 (rank #68 of 26416, 100th percentile) and 85025 (rank #59 of 32833, 100th percentile; described as an "extreme outlier, far above typical national volume for this code") are among the highest national performers, and several other routine codes (80048, 84443, 82306, 83036) also sit at or near top percentiles. These rankings indicate the provider is a major national volume performer for standard lab testing and likely operates high‑throughput automated platforms.
Mayo is a national leader for transplant‑related HLA testing: 86832 and 86833 each generate substantial Medicare revenue ($395.2K and $384.5K respectively) and both rank #2 of 22 providers nationally (95th percentile; noted as "notably above typical national volume for this code"). The prominence and revenue share of these HLA codes point to significant transplant or donor compatibility work in the lab’s specialty portfolio.
Medicaid competitive standing is more modest and localized: COVID PCR U0003 is the largest Medicaid revenue driver (2.3K claims, $27.8K revenue; rank #89 of 320 in‑state, 72th percentile) and routine panels like 80053 and 87497 have midrange in‑state ranks. Overall, Medicaid volumes and ranks show the provider participates in the state Medicaid market but is not a dominant Medicaid reference lab in Florida.
Investment in higher‑complexity molecular and genomic services is evident: Medicare revenue includes 81455 genomic panel ($185.6K, 3.5% of Medicare revenue), 81528 stool DNA test ($154.7K, 2.9%), and multiple nucleic‑acid/probe codes (87497, 87799) each contributing mid‑range revenue. The presence of these higher‑paid, lower‑claim‑count codes alongside very high‑volume routine testing suggests the lab mixes high‑throughput core testing with specialized, higher‑margin molecular diagnostics.
The provider’s NPI tenure—enumerated 2005-09-30 (~21 years ago)—indicates an established clinical laboratory presence. Combined with the national top‑percentile ranks on many core tests and leadership in select specialized assays, this tenure supports a profile of a mature, large‑scale reference and specialty laboratory operation rather than a recent or small entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
467 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. | 47,910 | $10 | $479.1K |
| 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… | 8,810 | $50 | $458.1K |
| 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… | 56,700 | $10 | $453.6K |
| 86832 | The lab analyst performs a solid phase immunoassay using patient serum to identify the presence of specific antibodies to specific Class I human leukocyte antigens, or HLA, using a high–definition… | 1,300 | $300 | $395.2K |
| 86833 | The lab analyst performs a solid phase immunoassay using patient serum to identify the presence of specific antibodies to specific Class II human leukocyte antigens, or HLA, using a high–definition… | 1,300 | $300 | $384.5K |
| 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… | 17,470 | $20 | $279.6K |
| 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… | 8,230 | $30 | $238.8K |
| 87497 | The lab analyst performs a test to quantify infection with cytomegalovirus, or CMV, using nucleic acid probe technique. CMV may cause severe illness in newborns and immunocompromised patients. | 4,860 | $40 | $209K |
| 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. | 4,650 | $40 | $186K |
| 81455 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as tumor tissue or bone marrow, for DNA and possibly RNA alterations in 51 or more genes known to… | 70 | $2,810 | $185.6K |
Showing 1–10 of 467
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 467 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
467 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81455 | 7 | 10 | 80 | $2,860 | $2M |
| 86832 | 1 | 10 | 1,300 | $300 | $395.2K |
| 86833 | 1 | 10 | 1,300 | $300 | $385K |
| 81450 | 2 | 10 | 20 | $740 | $322.2K |
| 88185 | 11 | 20 | 4,720 | $20 | $222.5K |
| 87798 | 66 | 110 | 590 | $30 | $218.6K |
| 88237 | 4 | 10 | 140 | $140 | $175.8K |
| 87150 | 36 | 40 | 1,660 | $30 | $173.2K |
| 87801 | 55 | 60 | 450 | $70 | $166.5K |
| 83521 | 6 | 10 | 3,990 | $20 | $163.5K |
Showing 1–10 of 467
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.
69 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 2,320 | $10 | $27.8K |
| 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. | 9,380 | $1 | $18.8K |
| 87497 | The lab analyst performs a test to quantify infection with cytomegalovirus, or CMV, using nucleic acid probe technique. CMV may cause severe illness in newborns and immunocompromised patients. | 2,360 | $10 | $14.2K |
| 82248 | The lab analyst measures the amount of direct bilirubin in a patient’s blood. Bilirubin is the yellow color pigment found in the bile, a fluid made by the liver. Direct bilirubin is a water soluble… | 4,650 | $1 | $4.6K |
| 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… | 1,900 | $1 | $3.8K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 1,770 | $1 | $3.5K |
| 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,… | 1,580 | $1 | $3.1K |
| 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. | 1,040 | $1 | $3.1K |
| 83880 | The lab analyst measures the amount of natriuretic peptide, a hormone made by heart muscle cells, in the patient specimen. Blood levels of the hormone increase in patients with congestive heart… | 950 | $1 | $2.8K |
| 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… | 2,180 | $1 | $2.2K |
Showing 1–10 of 69
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
69 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 89 | 320 | 750 | $40 | $232.7K |
| 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. | 248 | 640 | 4,400 | $10 | $193.4K |
| 84520 | The lab analyst performs a test to measure the amount of urea nitrogen in patient blood. | 232 | 300 | 1,170 | $60 | $186K |
| 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… | 61 | 70 | 180 | $20 | $178K |
| 82310 | The lab analyst measures the calcium level, primarily on a serum sample. | 162 | 220 | 880 | $50 | $151.3K |
| 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… | 391 | 440 | 610 | $40 | $111.5K |
| 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. | 132 | 460 | 510 | $50 | $110.2K |
| 84155 | The lab analyst performs the technical lab test to quantitate total protein in a serum, plasma, or whole blood specimen using one of several assay methods, excluding refractometry. Total protein is a… | 169 | 250 | 680 | $60 | $94.3K |
| 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… | 186 | 820 | 1,430 | $1 | $92.8K |
| 82040 | The lab analyst performs a quantitative measurement on a serum, plasma, or whole blood specimen for albumin. | 190 | 240 | 580 | $60 | $92.3K |
Showing 1–10 of 69
Other providers in the same ZIP code as Mayo Clinic Jacksonville, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.