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NPI 1316251358 · Spokane Valley, WA · Clinical Medical Laboratory
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Incyte Pathology, PLLC is a clinical medical laboratory provider located in Spokane Valley, Washington. This profile covers 202 Medicare and 58 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 | Incyte Pathology, PLLC |
| Address | 13103 E Mansfield Ave |
| City | Spokane Valley |
| State | WA |
| ZIP | 99216 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 2, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.2M |
| Medicaid | $159.4K |
Service-line profile: INCYTE PATHOLOGY, PLLC bills predominantly as an anatomic and clinical pathology laboratory with heavy reliance on surgical pathology and ancillary tissue testing. Its largest Medicare revenue driver is 88305 (surgical pathology level IV, $649K, 26.5% of Medicare revenue), supported by immunostain and in situ hybridization activity (88341 $175.6K and 88377 $163.4K), indicating routine receipt and interpretation of surgical specimens and specialized tumor testing. The presence of procedure-specific codes such as G0416 (prostate needle biopsy) and multiple immunohistochemistry/flow cytometry add‑ons reinforces a pathology-focused operation rather than a pure clinical chemistry lab.
Revenue concentration: Medicare revenue is concentrated in a small set of high-yield pathology codes — the precomputed top three Medicare codes (88305, 88341, 88377) account for 40.3% of the provider’s total Medicare revenue. Medicaid revenue is also somewhat concentrated: the precomputed top three Medicaid codes (36415, 85025, 84443) account for 36.0% of its total Medicaid revenue. These concentrations show the provider depends on a narrow set of anatomic pathology and high-throughput collection/panel services for a large share of payer receipts.
Payer mix and scale: The practice’s Medicare footprint ($3.2M) substantially exceeds its Medicaid activity ($159.4K), making Medicare the dominant payer by scale. Medicaid appears to be a much smaller volume channel for this entity, so payer negotiations or utilization patterns will be disproportionately influenced by Medicare relationships and reimbursement dynamics.
National competitive standing (Medicare): INCYTE posts high national ranks for multiple signature pathology and collection codes, reflecting above-average national volume for those services. Examples include 88305 (rank #197 of 14580, 99th percentile; described as notably above typical national volume), 88341 (rank #83 of 10274, 99th percentile; notably above typical national volume), and 36415 (rank #126 of 86467, 100th percentile; notably above typical national volume). These placements indicate a major national or multi-regional presence for specific anatomic pathology procedures and specimen collection activity relative to peers.
State competitive standing (Medicaid): By contrast, Medicaid code ranks place the lab as a modest participant within Washington state for routine clinical tests and collections. For example, 36415 ranks #132 of 552 in-state (76th percentile), 85025 ranks #129 of 265 (52th percentile), and 84443 ranks #91 of 149 (39th percentile), signaling middle-to-lower statewide market share for common clinical chemistry and hematology panels.
Statistical outliers and specialization signals: Several codes are flagged as clear outliers or substantially above typical peer volume, underlining specialization in anatomic pathology. Notably, 88304 is described as an "extreme outlier, far above typical national volume for this code," while 88305 and 88341 are both in the 99th percentile and labeled "notably above typical national volume." These labels corroborate a focused, high-volume surgical pathology practice rather than a generalized low-volume lab.
Operational throughput implication: High claim counts for specimen collection and routine panels show significant specimen throughput that supports its pathology workstream. Medicare claim volumes include 36415 (20.8K claims) and 80053 (13.9K claims), and Medicaid volumes include 36415 (5.5K claims) and 85025 (3.2K claims), indicating sustained, high-frequency phlebotomy and automated panel testing that likely feed the laboratory’s anatomic pathology caseload.
Commercial implications for payers and partners: The combination of concentrated, high-value anatomic pathology revenue (88305 and related immunostain/ISH codes) and dominant Medicare scale suggests this provider could be an important partner or contract target for payers seeking regional pathology capacity. Conversely, its modest Medicaid footprint suggests limited leverage or scale in state-managed programs, so payer strategies should treat Medicare relationships and anatomic pathology services as the primary drivers of value.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
202 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… | 12,250 | $50 | $649K |
| 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… | 2,550 | $70 | $175.6K |
| 88377 | The lab analyst applies a single multiplex in situ hybridization probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a… | 520 | $310 | $163.4K |
| 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. | 13,930 | $10 | $139.3K |
| 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… | 7,990 | $20 | $127.9K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 20,770 | $10 | $124.6K |
| 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,… | 1,480 | $80 | $115.3K |
| 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… | 14,000 | $10 | $112K |
| 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. | 8,390 | $10 | $109.1K |
| 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… | 890 | $100 | $86.6K |
Showing 1–10 of 202
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 202 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.
58 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 5,510 | $1 | $22K |
| 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… | 3,240 | $10 | $16.2K |
| 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… | 1,450 | $10 | $16K |
| 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. | 2,260 | $10 | $13.6K |
| 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. | 1,300 | $10 | $11.7K |
| 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… | 390 | $20 | $7.7K |
| 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).… | 1,180 | $10 | $7.1K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 1,170 | $10 | $7K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 330 | $20 | $6K |
| 86780 | The lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to Treponema pallidum, a spiral shaped bacteria called a spirochete, that causes syphilis. | 540 | $10 | $5.3K |
Showing 1–10 of 58
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
58 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… | 91 | 100 | 1,940 | $70 | $1M |
| 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… | 65 | 90 | 1,030 | $30 | $246.3K |
| 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… | 127 | 140 | 1,360 | $30 | $205.2K |
| 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. | 120 | 240 | 2,430 | $10 | $194.2K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 53 | 90 | 880 | $20 | $136.6K |
| 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… | 91 | 150 | 2,600 | $10 | $130K |
| 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. | 81 | 180 | 950 | $10 | $104.6K |
| 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… | 129 | 270 | 2,880 | $1 | $100.6K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 86 | 120 | 3,790 | $10 | $68.7K |
| 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… | 105 | 130 | 3,470 | $10 | $63.1K |
Showing 1–10 of 58
Other providers in the same ZIP code as Incyte Pathology, PLLC, ranked by combined Medicare and Medicaid revenue.
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