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NPI 1427776780 · Aurora, CO · Clinical Medical Laboratory
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Rocky Mountain Laboratories LLC is a clinical medical laboratory provider located in Aurora, Colorado. This profile covers 26 Medicare and 11 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 | Rocky Mountain Laboratories LLC |
| Address | 1411 S Potomac St Ste 330 |
| City | Aurora |
| State | CO |
| ZIP | 80012 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 22, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $5.9M |
| Medicaid | $41.6K |
This provider’s revenue is overwhelmingly Medicare‑driven: lifetime Medicare revenue is $5.9M versus lifetime Medicaid revenue of $41.6K, so Medicare accounts for virtually all billed dollars in the file. Medicaid activity exists but is minimal in dollar terms compared with Medicare, making the organization effectively Medicare‑dominant for revenue performance.
Medicare revenue is highly concentrated in a small set of NAAT/molecular infectious‑disease tests: the precomputed top three Medicare codes account for 86.9% of Medicare revenue, led by 87798 ($3.2M), 87801 ($1.4M), and 87481 ($479.2K). That concentration indicates the operation is tightly focused on amplified nucleic acid probe testing rather than a broad clinical lab mix.
The specific code mix supports a business model centered on high‑throughput molecular diagnostics. Top Medicare codes 87798 and 87801 are general amplified probe assays for infectious agents and multi‑pathogen testing, and the list includes respiratory, STI, GBS, MRSA, and VRE targets (examples include 87631, 87653, 87641, 87500), which together point to a reference or specialized molecular testing service line.
For several Medicare codes this provider is a national outlier and effectively a major provider in those tests: 87798 ranks #15 of 1319 providers nationally (99th percentile; extreme outlier, far above typical national volume) and 87801 ranks #6 of 561 providers nationally (99th percentile; extreme outlier). These rank/percentile positions indicate market dominance for specific high‑volume NAAT codes at the national level.
On the Medicaid side the top three codes are also concentrated, with the precomputed top three Medicaid codes accounting for 94.1% of Medicaid revenue; those are 87798 ($24.6K), 87801 ($12.7K), and 87631 ($2.3K). In‑state rank positions are more modest: 87798 ranks #5 of 41 in Colorado (90th percentile) and 87801 ranks #4 of 21 in‑state (85th percentile), showing above‑typical state activity but at a far smaller revenue scale than Medicare.
The dataset highlights some unusual reporting patterns that analysts should note: a high Medicare rank for 81003 (ranks #39 of 51536 nationally; 100th percentile; extreme outlier) appears in the top 25 despite generating only $10.5K of Medicare revenue, and several Medicaid line items show large claim counts but $0 avg paid/claim (for example 87641 and 87500 are present in Medicaid with $0 avg paid/claim). These points may reflect payment policy differences, cross‑billing practices, or data artifacts rather than service mix changes and merit follow‑up before operational conclusions are drawn.
The provider has a recent NPI tenure: enumerated 2022-08-22 (~4 years ago). Achieving the reported high national ranks on key molecular test codes within this timeframe suggests rapid scaling of molecular testing capacity or immediate alignment with referral/reflex testing workflows common to reference lab arrangements.
Taken together, the billing profile suggests a specialized, high‑throughput molecular infectious disease testing operation that is nationally competitive on a few NAAT codes (notably 87798 and 87801) and only marginally engaged with Medicaid in dollar terms. For payers and partner analysts, the combination of concentrated Medicare revenue, extreme national outlier status on specific codes, and minimal Medicaid dollars points to a narrow but high‑volume test portfolio to target in network contracting or utilization review discussions.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
26 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… | 94,150 | $30 | $3.2M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 20,430 | $70 | $1.4M |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 14,100 | $30 | $479.2K |
| 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,… | 6,410 | $30 | $218K |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 5,370 | $30 | $182.6K |
| 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… | 5,360 | $30 | $182.1K |
| 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,… | 300 | $140 | $42K |
| 87506 | The lab analyst performs a test to detect six to eleven types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal… | 160 | $250 | $39.8K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 1,030 | $30 | $34.9K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 760 | $30 | $25.8K |
Showing 1–10 of 26
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 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.
11 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… | 1,640 | $20 | $24.6K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 1,420 | $10 | $12.7K |
| 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,… | 30 | $70 | $2.3K |
| 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,… | 1,250 | $1 | $1.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,240 | $1 | $1.2K |
| 81003 | The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will… | 1,040 | $0 | $0 |
| 82570 | The lab analyst measures the amount of creatinine, in a patient specimen, other than blood. Creatinine is the waste material generated by the muscle tissue produced from the breakdown of creatine… | 10 | $0 | $0 |
| 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… | 880 | $0 | $0 |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 60 | $0 | $0 |
| 87641 | The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique. | 890 | $0 | $0 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 5 | 40 | 110 | $160 | $326K |
| 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,… | 24 | 30 | 170 | $100 | $197.7K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 7 | 10 | 100 | $30 | $122.2K |
| 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… | 3 | 10 | 490 | $30 | $116.8K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 6 | 20 | 290 | $40 | $112.1K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 4 | 20 | 130 | $40 | $69.9K |
| 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,… | 5 | 20 | 160 | $30 | $36.9K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 129 | 150 | 120 | $30 | $28.6K |
| 82570 | The lab analyst measures the amount of creatinine, in a patient specimen, other than blood. Creatinine is the waste material generated by the muscle tissue produced from the breakdown of creatine… | 34 | 30 | 170 | $1 | $16.1K |
| 81003 | The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will… | 55 | 260 | 190 | $1 | $4.1K |
Showing 1–10 of 11
Other providers in the same ZIP code as Rocky Mountain Laboratories LLC, ranked by combined Medicare and Medicaid revenue.
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