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NPI 1477522910 · Needham, MA · Clinical Medical Laboratory
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Cohen Dermatopathology, P.C. is a clinical medical laboratory provider located in Needham, Massachusetts. This profile covers 18 Medicare and 14 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 | Cohen Dermatopathology, P.C. |
| Address | 15 Crawford Street |
| City | Needham |
| State | MA |
| ZIP | 02494 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | March 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $7.5M |
| Medicaid | $3.5M |
COHEN DERMATOPATHOLOGY, P.C. operates as a clinical medical laboratory with a clear surgical pathology and immunohistochemistry focus: the practice’s Medicare and Medicaid top revenues are dominated by surgical pathology level IV (88305) plus immunostain and special stain codes (88342, 88312). On Medicare 88305 alone generated $4.9M and on Medicaid 88305 generated $2.3M, reflecting that the core business is slide-based diagnostic pathology rather than point-of-care or ambulatory procedures. This code mix is consistent with a pathologist-driven lab handling large surgical specimen volumes and downstream ancillary testing.
Revenue concentration is high on Medicare: the precomputed top 3 Medicare codes by revenue account for 83.9% of this provider's total Medicare revenue, driven by 88305 (65.7% of Medicare revenue), 88342 (11.8%), and 88312 (6.3%). Those three codes together create strong single-service-line dependency for Medicare receipts, so changes in reimbursement or referral patterns for surgical pathology and immunostains would materially affect Medicare revenue. The individual code dollar totals cited in the file (e.g., $4.9M for 88305) underscore how concentrated intake is around high-volume pathology casework.
Medicaid revenue is even more concentrated: the precomputed top 3 Medicaid codes by revenue account for 88.2% of this provider's total Medicaid revenue, with 88305 (66.1%), 88342 (11.9%), and 88312 (10.1%) as the primary drivers. Those three codes together produced the bulk of the $3.5M in Medicaid revenue on file, indicating the provider performs the same high-volume surgical pathology and staining work for Medicaid as it does for Medicare. The presence of multiple digitization add-on codes (0753T, 0760T, 0756T, 0757T, 0752T) in the Medicaid list also suggests workflow investments to support slide scanning tied to these high-volume services.
Payer mix shows Medicare scale is larger than Medicaid on file: total Medicare revenue is $7.5M versus total Medicaid revenue of $3.5M, so the provider is not single-payer but has a materially larger Medicare footprint. Both payers are meaningful to the business model — Medicaid contributes a sizable minority of lifetime revenue through the same core surgical pathology codes — which argues for operational capacity that serves mixed payer referrals. Analysts should treat both payers as relevant when modeling utilization or contracting impacts.
National competitive standing for the provider’s Medicare work is exceptional: 88305 ranks #6 of 14580 providers nationally (100th percentile; labeled an "extreme outlier"), 88342 ranks #8 of 11370 (100th percentile; "extreme outlier"), and 88312 ranks #28 of 6966 (100th percentile; "extreme outlier"). These rankings indicate COHEN DERMATOPATHOLOGY is a major national-volume performer on its primary pathology codes and is far above typical national volumes for those services. For payers, this profile signals a large, specialized capacity that may serve wide referral catchments or high-throughput central lab work.
State-level competitive standing on Medicaid underscores local dominance: the three highest Medicaid revenue codes (88305, 88342, 88312) each rank #1 in-state and are described as "extreme outlier" or 100th percentile for Massachusetts. That statewide leadership on the same surgical pathology and staining codes implies the practice is a primary regional destination for these services in Massachusetts and a meaningful counterparty for state Medicaid network considerations. Contracting or network strategy that ignores this provider’s local market share could risk access disruption for high-volume pathology services.
Operational detail: beyond core surgical pathology, the provider also reports high-volume immunohistochemistry and ancillary procedures (for example, Medicare entries like 88341 $422.4K, 88350 $190.6K, and 88346 $61.7K) which are all at or near very high national percentiles. These additional codes indicate routine use of multiple antibody stains and immunofluorescence techniques as part of diagnostic workflows, consistent with complex oncologic or dermatopathology case mixes. Presence of in situ hybridization entries (e.g., Medicare 88365, 88364; Medicaid 88189) further confirms capability for molecular-level slide interpretation rather than only basic histology.
Tenure and scale: the provider’s NPI was enumerated on 2006-03-16 (~20 years ago), indicating long-established operations, and lifetime reported Medicare revenue is $7.5M with Medicaid $3.5M on file. This longevity plus multi-million dollar lifetime receipts across both payers supports the interpretation of a stable, mature pathology practice rather than a new entrant. For financial or competitive analysis, historical tenure combined with the concentrated code mix suggests sustained specialization in high-volume surgical pathology and ancillary staining services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 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… | 88,180 | $60 | $4.9M |
| 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,… | 10,990 | $80 | $889.8K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 5,060 | $90 | $475.8K |
| 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… | 5,790 | $70 | $422.4K |
| 88120 | The lab analyst performs a technical lab test on a urinary tract specimen using in situ hybridization and three to five molecular probes for manual morphometric analysis, looking at the number and… | 400 | $560 | $225K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 1,800 | $110 | $190.6K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 2,740 | $60 | $169.8K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 2,520 | $30 | $85.8K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 450 | $140 | $61.6K |
| 88321 | A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received. | 170 | $80 | $12.4K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 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.
14 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… | 62,090 | $40 | $2.3M |
| 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,… | 15,320 | $30 | $413.6K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 12,130 | $30 | $351.7K |
| 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… | 2,730 | $50 | $144.5K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 9,760 | $10 | $136.7K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 5,230 | $20 | $109.8K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 330 | $20 | $7.9K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 150 | $40 | $5.4K |
| 0753T | This code describes clinical staff work performed to scan and digitize images from glass microscope slides for immediate or later pathologic diagnosis. This add–on code specifically describes… | 670 | $10 | $3.4K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 80 | $20 | $1.7K |
Showing 1–10 of 14
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
14 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 1 | 350 | 380 | $30 | $118.2K |
| 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 | 130 | 570 | $20 | $35.5K |
| 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… | 7 | 50 | 250 | $30 | $30.4K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 1 | 60 | 150 | $30 | $27.8K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 5 | 10 | 120 | $40 | $27.4K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 4 | 20 | 80 | $40 | $14.7K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 9 | 130 | 260 | $10 | $11.1K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 1 | 50 | 240 | $10 | $8.4K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 2 | 10 | 110 | $50 | $5.6K |
| 0753T | This code describes clinical staff work performed to scan and digitize images from glass microscope slides for immediate or later pathologic diagnosis. This add–on code specifically describes… | 1 | 10 | 500 | $1 | $2.1K |
Showing 1–10 of 14
Other providers in the same ZIP code as Cohen Dermatopathology, P.C., ranked by combined Medicare and Medicaid revenue.
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