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NPI 1326484569 · Grand Rapids, MI · Clinical Medical Laboratory
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Nxgen Mdx, LLC is a clinical medical laboratory provider located in Grand Rapids, Michigan. This profile covers 20 Medicare and 80 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 | Nxgen Mdx, LLC |
| Address | 801 Broadway Ave Nw |
| City | Grand Rapids |
| State | MI |
| ZIP | 49504 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 15, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $21.5M |
| Medicare | $1.8M |
NXGEN MDX, LLC presents as a clinical medical laboratory concentrated on molecular and genetic diagnostics: its Medicare mix is concentrated in amplified nucleic acid probe infectious-agent testing (notably codes 87798, 87481, 87500) while its Medicaid mix contains both high-volume infectious-agent/COVID testing (U0003) and large genetic panels (81220, 81420). The code descriptions and top-line revenue items point to a lab-focused operation that processes nucleic-acid amplification tests and clinical genomic panels rather than point-of-care or procedural services.
Medicare revenue is highly concentrated: the provider reports $1.8M in total Medicare revenue, with the top 3 Medicare codes accounting for 69.6% of that Medicare revenue. In particular, 87798 accounts for $898.6K (51.5% of Medicare revenue) and dominates the Medicare mix, indicating dependence on a relatively small set of amplified-probe infectious-agent tests for Medicare receipts.
Medicaid revenue is sizable and concentrated across a different set of services: total Medicaid revenue is $21.5M with the top 3 Medicaid codes accounting for 47.7% of Medicaid revenue. Those top Medicaid drivers include U0003 ($3.2M, 17.5%), 81220 ($2.8M, 15.4%), and 81420 ($2.7M, 14.7%), showing a mix of high-volume COVID testing and commercial/diagnostic genetic panels underpinning Medicaid revenue.
The provider is effectively Medicaid-focused in scale: reported Medicaid revenue of $21.5M compared with Medicare revenue of $1.8M indicates Medicaid is the dominant payer relationship for this entity. This payer mix suggests the lab’s commercial positioning and operational priorities are oriented toward state-contracted diagnostic and genetic testing volumes rather than Medicare-dominated service lines.
Competitive standing on Medicare is above average for several amplified-probe tests: 87798 ranks #72 of 1319 providers nationally (95th percentile) and 87481 ranks #61 of 1117 (95th percentile), which together with the precomputed 69.6% concentration implies an above-average national presence on a narrow set of tests even if those individual entries are labeled in the source as "typical, unremarkable volume." These national percentiles point to stronger-than-average activity on specific infectious-agent assays relative to most peers.
On Medicaid this provider is a major statewide participant for many molecular and genetic codes: multiple Medicaid codes are at rank #1 in-state and flagged as "extreme outlier" or at very high percentiles — for example 87481 ranks #1 of 44 (100th percentile; extreme outlier), 81514 ranks #1 of 21 (100th percentile; extreme outlier), and 87653 ranks #1 of 62 (100th percentile; extreme outlier). Those state-level positions indicate the lab captures unusually large Medicaid volumes for a range of targeted molecular and genomic tests compared with in-state peers.
Several codes are explicitly noted as "notably above typical state volume," reinforcing the lab’s outsized state role in pandemic-era and infectious testing: U0003 ranks #8 of 157 in-state (96th percentile; notably above typical state volume) and 87798 ranks #4 of 84 in-state (96th percentile; notably above typical state volume). These labels suggest the provider was an above-typical source of COVID and other amplified-probe testing for Medicaid patients during the period reflected in the data.
NXGEN MDX, LLC has an established enrollment history, with NPI enumeration dated 2013-05-15 (~13 years ago), which supports interpretation of these patterns as the output of a multi-year laboratory operation rather than a recent entrant. The combination of tenure plus concentrated, high-state-share Medicaid billing implies an operational focus on building and maintaining high-volume molecular and genetic testing services for the state payer mix.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 26,430 | $30 | $898.6K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 7,240 | $30 | $246.2K |
| 87500 | The lab analyst performs a test for vancomycin resistance in an infectious organism’s nucleic acid using amplified probe technique. VRE, vancomycin resistant enterococcus, is the most common organism… | 2,090 | $30 | $70.9K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 2,000 | $30 | $68.1K |
| 87563 | he lab analyst performs a test on a patient specimen such as blood, for Mycoplasma genitalium antigen detection using amplified nucleic acid probe technique. | 1,750 | $30 | $59.6K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 1,750 | $30 | $59.5K |
| 87529 | The lab analyst performs a test for Herpes simplex virus, HSV, using amplified nucleic acid probe technique. HSV causes clusters of blisters, or vesicles, on different parts of the body and spreads… | 1,710 | $30 | $58.2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 1,700 | $30 | $57.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 1,700 | $30 | $57.8K |
| 81514 | The lab analyst performs the technical lab tests on a vaginal fluid specimen for quantitative real–time amplification of DNA markers for six bacterial species listed in the code descriptor, and… | 220 | $260 | $57.6K |
Showing 1–10 of 20
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 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.
80 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… | 47,500 | $70 | $3.2M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 14,770 | $190 | $2.8M |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 18,100 | $150 | $2.7M |
| 81223 | The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR. | 590 | $2,650 | $1.6M |
| 87798 | The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified… | 10,230 | $120 | $1.3M |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 16,770 | $40 | $737.7K |
| 81222 | The lab analyst performs the technical lab test to analyze specific changes involving repeated or deleted nucleotides in the cystic fibrosis transmembrane conductance regulator gene, also known as… | 6,780 | $100 | $658K |
| 81405 | The lab analyst performs the technical lab tests to complete one of the specific genetic analyses listed in this Tier 2, Level 6 molecular pathology code. | 7,150 | $70 | $500.4K |
| 81259 | The lab analyst performs the technical lab test to analyze the entire gene sequence for alpha globin 1 and alpha globin 2 (HBA1/HBA) genes, which relate to alpha thalassemia and some structural… | 3,900 | $130 | $499.6K |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 2,870 | $130 | $364K |
Showing 1–10 of 80
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan median
80 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 2 | 10 | 160 | $180 | $2.3M |
| 81443 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The… | 2 | 10 | 3,360 | $610 | $2.1M |
| 81223 | The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR. | 1 | 10 | 590 | $2,650 | $1.6M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 2 | 10 | 190 | $180 | $910.5K |
| 81222 | The lab analyst performs the technical lab test to analyze specific changes involving repeated or deleted nucleotides in the cystic fibrosis transmembrane conductance regulator gene, also known as… | 1 | 10 | 6,780 | $100 | $659K |
| 81255 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for hexosaminidase A [alpha polypeptide], also known as HEXA. | 2 | 10 | 13,890 | $40 | $605.2K |
| 81329 | The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,… | 2 | 10 | 8,780 | $40 | $597K |
| 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… | 8 | 160 | 2,720 | $60 | $546.6K |
| 81251 | The lab analyst performs the technical lab test to detect the presence of specific changes in the gene for glucosidase, beta, acid, also known as GBA. | 2 | 10 | 14,930 | $40 | $536.2K |
| 81200 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for aspartoacylase, also known as ASPA. | 2 | 10 | 13,060 | $40 | $527.5K |
Showing 1–10 of 80
Other providers in the same ZIP code as Nxgen Mdx, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Cherry Street Services, Inc. | MI | Federally Qualified Health Center (FQHC) | $0 | $7.7M |
| James Starr | MI | Internal Medicine Physician | $210.9K | $0 |
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