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NPI 1508594136 · Lake Mary, FL · Clinical Medical Laboratory
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Cap Diagnostics LLC is a clinical medical laboratory provider located in Lake Mary, Florida. This profile covers 19 Medicare and 15 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 | Cap Diagnostics LLC |
| Address | 59 Skyline Dr Ste 1100 |
| City | Lake Mary |
| State | FL |
| ZIP | 32746 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 11, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $20M |
| Medicaid | $643.3K |
CAP DIAGNOSTICS LLC operates as a high-volume clinical molecular laboratory focused on amplified nucleic acid probe testing for infectious agents, with Medicare activity dominated by 87798, 87801, and 87481. On Medicare these codes appear at scale (87798: 310K claims, $10.5M revenue; 87801: 53.1K claims, $3.7M revenue; 87481: 72.5K claims, $2.5M revenue), and Medicaid claims for the same assays (87798: 4.8K claims, $332.1K; 87801: 5.4K claims, $129.8K; 87481: 5.6K claims, $84.5K) reflect a consistent service mix across payers focused on molecular infectious-disease diagnostics. These CPT/HCPCS descriptions (broad NAAT for unspecified agents, multiplex infectious-agent testing, and Candida NAAT) indicate core capabilities in high-throughput nucleic-acid amplification testing and routine STI/colonization panels used in ambulatory and surveillance contexts.
Revenue concentration is extreme in both payers: the provider’s top three Medicare codes account for 83.8% of Total Medicare revenue, and the top three Medicaid codes account for 84.7% of Total Medicaid revenue. This concentration — driven by 87798, 87801, and 87481 — signals that a few high-volume NAAT assays drive the majority of billed dollars for each payer, making the business heavily dependent on continued reimbursement and referral volume for those specific tests.
Payer mix is heavily skewed toward Medicare: Total Medicare revenue is $20M versus Total Medicaid revenue of $643.3K, so the provider is effectively Medicare‑driven in scale. While the same assay types appear in Medicaid, Medicaid revenue is a small fraction of the provider’s overall billing profile, indicating Medicare pricing and volume dynamics are the dominant business driver.
National competitive standing on Medicare is dominant for the core NAAT codes: 87801 ranks #1 of 561 providers nationally and is labeled an extreme outlier, while 87798 (rank #3 of 1319) and 87481 (rank #3 of 1117) are also 100th‑percentile extreme outliers. Those rank positions and the very large Medicare claim counts and revenues indicate CAP DIAGNOSTICS is a major national player for these specific amplified-probe molecular assays, operating well above typical national volumes for those codes.
By contrast, the Medicaid picture is strong but more typical within Florida. For Medicaid the same high-revenue codes sit in high but not extreme state percentiles (87798: rank #32 of 194, 84th percentile; 87801: rank #14 of 89, 85th percentile; 87481: rank #10 of 86, 89th percentile), with several related assays ranking notably above typical state volume (87500 rank #4 of 38, 92nd percentile; 87511 rank #2 of 26, 96th percentile; 87653 rank #6 of 67, 92nd percentile). This pattern suggests the provider is a strong in‑state participant for a broad set of molecular infectious‑disease tests, but not as singularly dominant in Medicaid as it is nationally on Medicare.
Operational scale is suggested by very large Medicare claim volumes for core assays, which are consistent with high-throughput laboratory workflows: examples include 310K claims for 87798, 72.5K claims for 87481, and 53.1K claims for 87801. Those absolute claim counts, alongside the revenue share concentration, imply capacity to process large specimen volumes and to support routine, repeated NAAT testing across many referring sources.
Despite a relatively recent NPI enumeration date (2022-08-11, ~4 years ago), the provider reports substantial volume and revenue on Medicare and measurable activity on Medicaid. The combination of a short tenure since enumeration and rapid accrual of high-volume NAAT billing may be relevant for network planning and capacity assessments, but the data do not indicate reasons for growth beyond the observed claim and revenue figures.
COVID-era and multiplex respiratory testing represent only a small portion of billed revenue relative to core NAAT services: Medicare U0003 appears with 450 claims and $33.3K revenue (0.2% of Medicare revenue) and multiplex respiratory testing (87637) shows 232 claims and $32.5K (0.2%). These limited revenues for pandemic-specific and multiplex panels suggest the lab’s business remained concentrated on its primary infectious-disease NAAT menu rather than pivoting primarily to high-volume SARS‑CoV‑2 testing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 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… | 309,980 | $30 | $10.5M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 53,110 | $70 | $3.7M |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 72,480 | $30 | $2.5M |
| 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… | 23,880 | $30 | $811.9K |
| 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,… | 23,880 | $30 | $811.9K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 23,840 | $30 | $810.4K |
| 87511 | The lab analyst performs a test for Gardnerella vaginalis using amplified nucleic acid probe technique. Gardnerella vaginalis, typically causes bacterial vaginosis, an infection of the vagina that… | 16,140 | $30 | $548.8K |
| 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… | 450 | $70 | $33.3K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 230 | $140 | $32.5K |
| 87556 | The lab analyst performs a test for Mycobacterium tuberculosis using amplified nucleic acid probe technique. Mycobacteria tuberculosis are sometimes called acid fast bacteria because of the special… | 590 | $40 | $24.2K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
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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.
15 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… | 4,810 | $70 | $332.1K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 5,410 | $20 | $129.8K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 5,640 | $20 | $84.5K |
| 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… | 4,820 | $10 | $24.1K |
| 87511 | The lab analyst performs a test for Gardnerella vaginalis using amplified nucleic acid probe technique. Gardnerella vaginalis, typically causes bacterial vaginosis, an infection of the vagina that… | 4,530 | $10 | $22.6K |
| 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,… | 4,740 | $1 | $19K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 4,740 | $1 | $19K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 280 | $10 | $3.1K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 270 | $10 | $2.9K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 220 | $10 | $2.4K |
Showing 1–10 of 15
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
15 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 317 | 320 | 750 | $40 | $232.7K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 234 | 340 | 720 | $10 | $100.6K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 14 | 90 | 320 | $20 | $100.3K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 45 | 80 | 240 | $10 | $92.2K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 232 | 330 | 690 | $10 | $61.6K |
| 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… | 32 | 190 | 640 | $10 | $59.9K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 10 | 90 | 430 | $10 | $23.3K |
| 87511 | The lab analyst performs a test for Gardnerella vaginalis using amplified nucleic acid probe technique. Gardnerella vaginalis, typically causes bacterial vaginosis, an infection of the vagina that… | 2 | 30 | 380 | $10 | $16.6K |
| 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… | 29 | 40 | 410 | $10 | $12.2K |
| 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 | 70 | 560 | $10 | $9.6K |
Showing 1–10 of 15
Other providers in the same ZIP code as Cap Diagnostics LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Quality Assured Services Inc. | FL | Durable Medical Equipment & Medical Supplies | $14.5M | $20.2M |
| Wpi Acquisition Corp. | FL | Durable Medical Equipment & Medical Supplies | $0 | $33.5M |
| Florida Autism Center | FL | Behavior Analyst | $0 | $8.6M |
| Trumpet Behavioral Health, LLC | FL | Behavior Analyst | $0 | $7.7M |
| Thomas Barnard | FL | Ophthalmology Physician | $4.5M | $6.5K |
| Filutowski Eye Institute PA | FL | Ambulatory Surgical Clinic/Center | $894.5K | $25.6K |
| Michael Burton | FL | Plastic and Reconstructive Surgery Physician | $585K | $0 |
| Maha Ansara | FL | Endocrinology, Diabetes & Metabolism Physician | $518.8K | $0 |
| Muhammad Chughtai | FL | Infectious Disease Physician | $518.2K | $0 |
| Lake Mary Surgery Center LLC | FL | Ambulatory Surgical Clinic/Center | $502.6K | $0 |
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