Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Texas (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Rfa Medical Solutions LLC (NPI 1437839420)

Key Findings

Field	Value
Entity Type	Organization
Organization	Rfa Medical Solutions LLC
Address	833 E Arapaho Rd Ste 110
City	Richardson
State	TX
ZIP	75081
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	July 24, 2023

Payer Source	Total Paid
Medicare	$6.4M
Medicaid	$0

RFA MEDICAL SOLUTIONS LLC is filed under the Clinical Medical Laboratory taxonomy and its Medicare billing mix is dominated by multi-gene genomic sequencing panels. The top three revenue-driving CPTs are 81440 ($2M revenue), 81443 ($1.5M revenue), and 81419 ($1.5M revenue), each representing complex genomic testing for panels of 100+, ~15, and ~24 genes respectively, which indicates the operation focuses on specialized genetic diagnostics rather than routine clinical chemistry or anatomic pathology services.

Revenue concentration is high: the precomputed top-3 codes account for 78.0% of this provider's total Medicare revenue while total Medicare revenue is $6.4M. That concentration means the provider’s revenue stability is tightly linked to utilization and reimbursement dynamics for a small set of high-value genomic panels.

This provider is effectively a Medicare-only biller: lifetime Medicare revenue is $6.4M and there is no Medicaid billing on file. From a payer-mix perspective, state Medicaid programs have no recorded exposure to this entity, so commercial and Medicare contractors are the primary financial stakeholders.

RFA MEDICAL SOLUTIONS shows a national competitive standing as a dominant provider for several high-value tests. 81440 ranks #1 of 13 providers nationally (100th percentile; notably above typical national volume) with 624 claims and $3258 avg paid/claim; 81443 ranks #1 of 14 (100th percentile; notably above typical national volume) with 624 claims and $2400 avg paid/claim; 81419 is a strong national participant at #4 of 27 (88th percentile) with 619 claims and $2400 avg paid/claim.

Beyond the top three, the provider also posts notably high relative activity for certain other genomic panels. For example, 81448 (peripheral‑neuropathy panel) has $357.6K revenue and ranks #1 of 13 providers nationally (100th percentile; notably above typical national volume) with 624 claims and $573 avg paid/claim, while many single‑gene technical tests such as 81317 ($173.7K; 262 claims; $663 avg paid/claim; 70th percentile) and 81298 ($166.7K; 265 claims; $629 avg paid/claim; 67th percentile) sit in mid-range national percentiles consistent with typical laboratory volume.

Claims-level throughput and per-claim reimbursement both support a specialized, high-cost testing model. The top panels all report high average paid/claim figures ($3258 for 81440, $2400 for 81443, $2400 for 81419) and claim volumes in the 600-range for those panels, which is consistent with a focused service line that processes many instances of a few high-value tests rather than a broad mix of low-cost assays.

The provider’s NPI was enumerated on 2023-07-24 (~3 years ago), so this scale of Medicare billing—$6.4M in lifetime Medicare revenue—was achieved over a relatively short operational tenure. That combination of recent enumeration and concentrated high-value test volume suggests rapid scale-up in specialized genomic testing capacity since enrollment.

For payers and network managers, the profile signals concentrated exposure to a small set of expensive genomic panels and negligible Medicaid exposure. Medicare contractors should monitor utilization trends and denial patterns for 81440, 81443, and 81419 given their outsized contribution to revenue, while state Medicaid programs are unlikely to need immediate contracting or utilization-management focus because there is no Medicaid billing on file.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
81440	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 100 mitochondrial genes encoded in the nucleus, including 19 specific…	620	$3,260	$2M
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…	620	$2,400	$1.5M
81419	The lab analyst performs the technical lab test on a specimen such as blood to conduct a genomic sequence analysis panel. The test evaluates the genetic sequences of at least the 24 genes listed in…	620	$2,400	$1.5M
81448	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least five peripheral–neuropathy–related genes, such as the eight gene examples…	620	$570	$357.6K
81317	The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene.	260	$660	$173.7K
81298	The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene.	270	$630	$166.7K
81307	The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene.	250	$660	$165.8K
81249	The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene.	250	$590	$149.4K
81238	The lab analyst performs the technical lab test to analyze the full gene sequence of the coagulation factor IX (F9) gene.	250	$590	$144.6K
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.	260	$490	$124.7K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caregivers Home Health Tx Inc	TX	Home Health Agency	$0	$478M
Apple Homecare Medical Supply LLC	TX	Durable Medical Equipment & Medical Supplies	$0	$123.3M
Hope Pediatrics LLC	TX	Home Health Agency	$0	$77.9M
Abc Home Medical Supply, Inc.	TX	Durable Medical Equipment & Medical Supplies	$0	$22.8M
Trident Diagnostics Limited Liability Company	TX	Clinical Medical Laboratory	$14.9M	$66.7K
Cabot Lab LLC	TX	Clinical Medical Laboratory	$278.1K	$1.2M
Curie Dx Laboratory LLC	TX	Clinical Medical Laboratory	$664.4K	$2.8K
Shahida Rafiq	TX	Family Medicine Physician	$232.7K	$0
Pearl Ezegrim	TX	Psychiatric/Mental Health Nurse Practitioner	$110.1K	$40
Francis Lister	TX	Optometrist	$23.8K	$0

Rfa Medical Solutions LLC — Billing Profile & Reimbursement Data

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Rfa Medical Solutions LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81419	2	10	80	$2,400	$666.2K
81440	1	10	70	$3,250	$634.3K
81443	1	10	70	$2,400	$467.4K
81317	8	20	220	$660	$382.7K
81298	8	20	220	$630	$362.7K
81307	8	20	150	$660	$361.4K
81249	8	20	80	$590	$319.2K
81238	8	20	110	$590	$281.7K
81223	9	30	70	$450	$197.4K
81448	1	10	70	$570	$111.7K