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NPI 1306875877 · New Haven, CT · Clinical Medical Laboratory
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Yale University is a clinical medical laboratory provider located in New Haven, Connecticut. This profile covers 53 Medicare and 56 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 | Yale University |
| Address | 20 York St |
| City | New Haven |
| State | CT |
| ZIP | 06510 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $10.4M |
| Medicare | $1.4M |
YALE UNIVERSITY operates as a high‑complexity clinical medical laboratory: its Medicare and Medicaid portfolios are dominated by molecular and cytogenetic testing (examples include 81479, 81415, 81229, 88271, 88275) alongside surgical pathology and IHC services (88305, 88341, 88342) and high-volume infectious/screening assays (82306, 87624). The mix of high-dollar molecular codes and very large claim volumes for routine analytes suggests a centralized laboratory model that handles both complex genomic testing and mass screening workflows.
Revenue concentration differs by payer: for Medicare the top three codes account for 31.2% of Medicare revenue with 88305 contributing 17.1% of Medicare revenue, 88275 contributing 7.3%, and 88271 contributing 6.8%. For Medicaid the top three codes account for 46.5% of Medicaid revenue with 81479 at 25.1%, 88305 at 11.7%, and 81415 at 9.8%, indicating Medicaid income is more concentrated in a few high‑value molecular/genomic services.
YALE UNIVERSITY’s payer mix is heavily weighted toward Medicaid in scale: total Medicaid revenue is $10.4M compared with total Medicare revenue of $1.4M, so Medicaid is the primary revenue source on file. This distribution makes the provider effectively a Medicaid-centered lab operation in financial terms, with Medicare representing a smaller portion of billed activity.
On Medicare competitive standing there are mixed signals: many common pathology and lab codes show high national percentiles but are described as typical or unremarkable volume (for example 88305 ranks #841 of 14580, 94th percentile). However, select cytogenetics and consult codes are much higher than peers — 88271 ranks #5 of 74 (95th percentile, described as notably above typical national volume for this code) and 88275 ranks #5 of 72 (94th percentile). Notably, 88321 is labeled an "extreme outlier, far above typical national volume for this code," indicating unusually high national-level activity for consultative pathology interpretation.
In-state competitive standing on Medicaid shows clear dominance in advanced genetic testing and cytogenetics: 81479 ranks #1 of 4 in-state (100th percentile) and 81415 ranks #1 of 1 in-state (no peer comparison available), while 88271, 88237 and 88264 each rank #1 among small in-state peer sets (100th percentile for those codes). These positions indicate the provider is a major state-level hub for high‑complexity genomic and cytogenetic services.
Operational footprint is reflected in claim volumes for routine and screening tests on Medicaid: 88175 shows 33K claims, 88305 shows 30.8K claims, 87624 shows 27.9K claims, and 82306 shows 25.9K claims, which together point to very high-throughput processing for cytology, HPV testing, vitamin D and related assays. By contrast Medicare claim counts for the same codes are much lower (e.g., 88305 at 3.9K claims), suggesting the lab’s mass testing throughput is driven primarily by Medicaid and possibly non-Medicare commercial or public health contracts.
The provider has an established tenure in the market, with its NPI enumerated on 2006-06-30 (~20 years ago). This long enumeration period aligns with the scale and breadth of services reported and supports interpretation of the observed state-level leadership in specialized testing and sustained high Medicaid volumes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
53 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… | 3,880 | $60 | $225K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 1,910 | $50 | $95.3K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 4,250 | $20 | $89.3K |
| 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. | 1,110 | $80 | $87.7K |
| 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… | 1,020 | $70 | $74.2K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 500 | $140 | $70.5K |
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 40 | $1,790 | $66.2K |
| 88264 | The analyst performs a chromosome analysis and analyzes 20 to 25 cells. The analysis includes counting the number of chromosomes in each cell and preparing a karyotype for each cell examined. | 460 | $140 | $65.3K |
| 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… | 2,110 | $30 | $61.3K |
| 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… | 190 | $320 | $60.1K |
Showing 1–10 of 53
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 53 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
53 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 88120 | 4 | 10 | 80 | $370 | $172K |
| 88275 | 2 | 10 | 1,910 | $50 | $106.1K |
| 88271 | 2 | 10 | 4,250 | $20 | $82.1K |
| 88237 | 2 | 10 | 460 | $140 | $64K |
| 86833 | 1 | 10 | 190 | $320 | $60.2K |
| 86832 | 1 | 10 | 190 | $310 | $59.8K |
| 88264 | 2 | 10 | 460 | $140 | $55.3K |
| 81162 | 1 | 10 | 30 | $1,790 | $48.3K |
| 88305 | 8 | 200 | 410 | $40 | $44.6K |
| 88369 | 2 | 10 | 140 | $100 | $39K |
Showing 1–10 of 53
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
56 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 1,020 | $2,330 | $2.4M |
| 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… | 30,820 | $40 | $1.1M |
| 81415 | The lab analyst performs an exome gene sequence analysis to look for genetic changes that could account for an unexplained disorder or syndrome in the patient. | 320 | $2,870 | $927.7K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 27,890 | $30 | $780.8K |
| 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… | 25,900 | $20 | $621.6K |
| 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… | 33,000 | $10 | $429K |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 580 | $670 | $386.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 10,820 | $30 | $324.4K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 10,660 | $30 | $319.8K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 5,130 | $50 | $241K |
Showing 1–10 of 56
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
56 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81415 | The lab analyst performs an exome gene sequence analysis to look for genetic changes that could account for an unexplained disorder or syndrome in the patient. | 1 | 10 | 320 | $2,870 | $927.8K |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 1 | 10 | 830 | $850 | $620.4K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 20 | 30 | 5,480 | $60 | $581.1K |
| 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 | 90 | 3,980 | $40 | $424.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 15 | 50 | 4,240 | $30 | $410.4K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 15 | 50 | 4,240 | $30 | $409.9K |
| 81408 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 9 molecular pathology code. | 3 | 10 | 230 | $100 | $378.4K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 14 | 20 | 1,770 | $30 | $278.8K |
| 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,… | 36 | 50 | 4,960 | $20 | $273.9K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 2 | 30 | 3,460 | $30 | $219.9K |
Showing 1–10 of 56
Other providers in the same ZIP code as Yale University, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Philip M Perrino P.C. | CT | Optometrist | $0 | $4.7M |
| Dva Renal Healthcare Inc | CT | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $4.4M |
| The Connection Inc. | CT | Adult Mental Health Clinic/Center | $0 | $4M |
| Chapel Street Dental P.C. | CT | General Practice Dentistry | $0 | $1.1M |
| Neha Gowali | CT | Diagnostic Radiology Physician | $732.6K | $0 |
| Mariam Totonchy | CT | Dermatology Physician | $488.3K | $0 |
| Nicholas Vu | CT | Diagnostic Radiology Physician | $472.5K | $1.7K |
| Christopher Stamey | CT | Dermatology Physician | $413K | $0 |
| Marc Levin | CT | Diagnostic Radiology Physician | $391.9K | $0 |
| David Leffell | CT | Dermatology Physician | $359.9K | $0 |
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