Loading...
NPI 1396833026 · Omaha, NE · Clinical Medical Laboratory
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Physicians Laboratory Services, Inc is a clinical medical laboratory provider located in Omaha, Nebraska. This profile covers 192 Medicare and 160 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 | Physicians Laboratory Services, Inc |
| Address | 4840 F St |
| City | Omaha |
| State | NE |
| ZIP | 68117 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.6M |
| Medicare | $2.4M |
PHYSICIANS LABORATORY SERVICES, INC is operating as a high-throughput clinical diagnostic laboratory (Taxonomy: Clinical Medical Laboratory) with a code mix dominated by routine chemistry, hematology and infectious-disease nucleic acid testing. Medicare top codes such as 80053, 84443 and 85025 appear on the Medicare roster while Medicaid activity is heavily weighted toward molecular infectious testing (U0003, U0005) and STI NAATs (87491, 87591), consistent with a centralized lab that processes large batches of specimens. The NPI was enumerated 2006-10-10 (~20 years ago), indicating long tenure in the market and likely established collection and processing workflows.
Revenue concentration on Medicare is material: the provider reports $2.4M total Medicare revenue and the precomputed top-3 Medicare codes account for 33.9% of that Medicare revenue. Those three are 80053 ($236.2K revenue, 13.3% of Medicare revenue, 23.6K claims), 84443 ($198.4K revenue, 11.2% of Medicare revenue, 12.4K claims) and 85025 ($165K revenue, 9.3% of Medicare revenue, 20.6K claims), showing a reliance on routine panels and CBCs to drive a large share of Medicare receipts.
Medicaid revenue is larger than Medicare for this provider: total Medicaid revenue is $3.6M, and the precomputed top-3 Medicaid codes account for 39.2% of the provider's Medicaid revenue. The Medicaid top three are U0003 ($578.1K revenue, 20.7% of Medicaid revenue, 10.9K claims), 87491 ($263.4K revenue, 9.4% of Medicaid revenue, 10.5K claims) and 87591 ($252.6K revenue, 9.1% of Medicaid revenue, 10.5K claims), indicating that COVID PCR and STI NAAT testing have been major Medicaid revenue drivers.
On competitive standing for Medicare services, this provider posts high national percentiles on many routine lab codes, frequently in the 97th–100th percentile. Examples include 80053 (rank #119 of 26416, 100th percentile, labeled "typical, unremarkable volume"), 84443 (rank #116 of 19722, 99th percentile) and 85025 (rank #126 of 32833, 100th percentile, labeled "notably above typical national volume"). These ranks suggest the provider is a high-volume national participant for common chemistry and hematology tests rather than a marginal lab.
State-level competitive standing on Medicaid shows clear dominance in specific niches: U0003 is ranked #1 of 29 in-state (100th percentile) and labeled an "extreme outlier, far above typical state volume," and several other codes such as 87653 (rank #1 of 7, 100th percentile), 87661 (rank #1 of 10, 100th percentile) and 86762 (rank #1 of 10, 100th percentile) also appear as top in-state performers. At the same time, many routine panels and specimen-collection codes (e.g., 36415 with 50.3K claims and $50.3K revenue, ranked #5 of 270, labeled "extreme outlier, far above typical state volume") indicate unusually large specimen throughput within the state.
Operational throughput is evident from large claim volumes across both payers, consistent with centralized specimen collection plus lab processing. Example volumes include 27.9K Medicaid claims for 80053 ($139.6K revenue), 46.4K Medicaid claims for 85025 ($139.2K revenue), and 23.6K Medicare claims for 80053 ($236.2K revenue), pointing to sustained high specimen counts and likely automation to handle that scale.
The payer-mix and code mix indicate revenue sensitivity to episodic demand shifts: a meaningful portion of Medicaid revenue comes from pandemic-era molecular codes (U0003 at $578.1K, 20.7% of Medicaid revenue; U0005 at $112.6K, 4.0% of Medicaid revenue), while Medicare revenue remains concentrated in routine panels (top-3 = 33.9%). This pattern suggests the provider's recent Medicaid revenue was substantially influenced by COVID-era testing demand, whereas its Medicare business is anchored in steady diagnostic panels and screening tests.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
192 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. | 23,620 | $10 | $236.2K |
| 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… | 12,400 | $20 | $198.4K |
| 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… | 20,620 | $10 | $165K |
| 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. | 12,590 | $10 | $163.6K |
| 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… | 3,680 | $30 | $106.7K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 10,240 | $10 | $81.9K |
| 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… | 9,840 | $10 | $78.7K |
| 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. | 1,720 | $40 | $68.8K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 11,070 | $10 | $66.4K |
| 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).… | 6,150 | $10 | $61.5K |
Showing 1–10 of 192
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 192 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.
160 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… | 10,910 | $50 | $578.1K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 10,530 | $30 | $263.4K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 10,520 | $20 | $252.6K |
| 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. | 27,920 | $10 | $139.6K |
| 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… | 4,970 | $30 | $139.3K |
| 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… | 46,390 | $1 | $139.2K |
| 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… | 17,600 | $10 | $123.2K |
| 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,… | 7,510 | $20 | $112.6K |
| 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. | 5,000 | $20 | $110K |
| 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… | 6,350 | $20 | $101.6K |
Showing 1–10 of 160
How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nebraska median
160 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 9 | 20 | 210 | $40 | $91.3K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 3 | 30 | 730 | $30 | $89.8K |
| 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. | 4 | 10 | 1,240 | $30 | $78.5K |
| 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… | 1 | 30 | 110 | $70 | $74.9K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 3 | 30 | 720 | $20 | $73.6K |
| 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. | 7 | 130 | 1,410 | $10 | $69.2K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 21 | 30 | 140 | $120 | $54.7K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 16 | 30 | 990 | $20 | $54K |
| 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… | 6 | 40 | 530 | $20 | $53.8K |
| 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… | 4 | 150 | 1,610 | $10 | $47K |
Showing 1–10 of 160
Other providers in the same ZIP code as Physicians Laboratory Services, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Kci Usa, Inc. | NE | Durable Medical Equipment & Medical Supplies | $0 | $3.4M |
| Madison County Medical Equipment, Inc | NE | Oxygen Equipment & Supplies (DME) | $0 | $1.4M |
| Chi National Home Care, LLC | NE | Home Infusion Agency | $0 | $987.2K |
| Physicians Laboratory, PC | NE | Clinical Medical Laboratory | $289.6K | $465.3K |
| Project Harmony | NE | Clinic/Center | $0 | $559.4K |
| Omni Behavioral Health | NE | Community/Behavioral Health Agency | $0 | $365.8K |
| Wayne Penka | NE | Anatomic Pathology & Clinical Pathology Physician | $82.8K | $0 |
| Natalie Specht-bartman | NE | Physical Therapist | $43.9K | $0 |
| David Jaskierny | NE | Anatomic Pathology & Clinical Pathology Physician | $30.7K | $0 |
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.