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NPI 1578564373 · Rapid City, SD · Clinical Medical Laboratory
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Geib, Elston, Frost Professional Association is a clinical medical laboratory provider located in Rapid City, South Dakota. This profile covers 32 Medicare and 12 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 | Geib, Elston, Frost Professional Association |
| Address | 2805 5th St |
| City | Rapid City |
| State | SD |
| ZIP | 57701 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 3, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.1M |
| Medicare | $692.9K |
This lab reports lifetime Medicare revenue of $692.9K and lifetime Medicaid revenue of $1.1M, making Medicaid the larger payer relationship by absolute dollars. The difference in scale suggests the practice operates with a substantial state Medicaid referral base while still maintaining meaningful Medicare activity.
Revenue is highly concentrated by a small set of pathology codes: the top 3 Medicare codes account for 79.0% of Medicare revenue and the top 3 Medicaid codes account for 82.9% of Medicaid revenue. For Medicare the dominant drivers are 88305, 88307, and 88342; for Medicaid the dominant drivers are 88305, 88307, and 88175, indicating dependence on a few high-volume pathology services.
The mix of high-revenue codes (88305 and 88307) together with substantial volumes of immunohistochemistry/antibody staining codes such as 88342 and cytology screening 88175 indicates this entity functions primarily as a surgical pathology and diagnostic histology/immunohistochemistry laboratory. Reported claim volumes reinforce that operational profile: Medicare 88305 shows 14.1K claims and Medicaid 88305 shows 9.9K claims, consistent with a high-throughput specimen processing operation.
Payer-level reimbursement patterns differ by code: average paid per claim for 88305 is $31 on Medicare versus $61 on Medicaid, and for 88307 it is $66 on Medicare versus $103 on Medicaid. Those per-claim differences imply materially higher Medicaid reimbursement for the practice’s top surgical pathology services, which amplifies Medicaid’s larger role in total revenue.
On national Medicare benchmarks this provider is a pronounced outlier for key surgical pathology codes: 88305 ranks #145 of 14580 providers (99th percentile; extreme outlier) and 88307 ranks #5 of 8511 providers (100th percentile; extreme outlier), while 88342 ranks #251 of 11370 providers (98th percentile; notably above typical national volume). These rankings indicate the provider is a major national-volume contributor for selected pathology services rather than a modest local participant.
Within South Dakota Medicaid volume and rankings also position the practice as a leading in-state pathology provider: 88305 ranks #3 of 24 providers in-state (91th percentile; notably above typical state volume) and 88307 ranks #2 of 7 providers in-state (83th percentile). Additional codes such as 88304 rank #1 of 6 providers in-state (100th percentile), reinforcing a strong local competitive standing in surgical pathology services.
The provider has an NPI enumeration date of 2005-08-03 (~21 years ago), indicating a long tenure in the market. Combined with concentrated code-level volumes and high national/state ranks, the longevity supports the view of an established, high-throughput pathology practice likely serving a broad referral network.
The heavy dependence on a few high-volume surgical pathology and cytology codes creates business sensitivity: changes in referral patterns, contract terms for 88305/88307, or reimbursement levels for these codes could materially affect overall revenue given that the top code groups drive the majority of both Medicare and Medicaid income.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
32 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… | 14,130 | $30 | $437.9K |
| 88307 | The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,060 | $70 | $69.8K |
| 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 | $40 | $41.6K |
| 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… | 1,030 | $20 | $24.7K |
| 88361 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. The lab analyst processes the slides using computer assisted… | 470 | $30 | $15.5K |
| 88173 | The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate and then interprets and reports the results. | 240 | $60 | $14.2K |
| 88309 | The physician, typically a pathologist, performs a level VI examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 130 | $110 | $13.9K |
| 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. | 200 | $70 | $12.9K |
| 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… | 300 | $40 | $10.5K |
| 88331 | Pathological, or intraoperative, consultation provides necessary and precise information pertaining to diagnosis and prognosis which aid a surgeon in deciding whether to proceed further or not during… | 180 | $50 | $8.5K |
Showing 1–10 of 32
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 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.
12 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… | 9,870 | $60 | $602.3K |
| 88307 | The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 2,120 | $100 | $218.8K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 2,780 | $30 | $72.2K |
| 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… | 2,380 | $30 | $66.7K |
| 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. | 1,910 | $30 | $57.2K |
| 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,… | 810 | $40 | $31.5K |
| 85060 | The physician, typically a clinical pathologist, performs a peripheral blood smear review and provides an interpretation and written report of the examination. | 1,010 | $10 | $10.1K |
| 88302 | The physician, typically a pathologist, performs a level II examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 390 | $20 | $6.6K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 120 | $50 | $6.1K |
| 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… | 40 | $100 | $4K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. South Dakota median
12 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… | 3 | 20 | 210 | $50 | $104.8K |
| 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 | 1,000 | $30 | $83.4K |
| 88307 | The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 2 | 10 | 970 | $60 | $78.7K |
| 88175 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 4 | 10 | 1,430 | $20 | $57.5K |
| 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… | 1 | 10 | 1,190 | $20 | $21.8K |
| 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,… | 4 | 10 | 810 | $20 | $16.3K |
| 85060 | The physician, typically a clinical pathologist, performs a peripheral blood smear review and provides an interpretation and written report of the examination. | 2 | 10 | 460 | $10 | $5.8K |
| 88302 | The physician, typically a pathologist, performs a level II examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 2 | 10 | 360 | $10 | $3.8K |
| 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… | 4 | 10 | 50 | $60 | $3.7K |
| 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… | 3 | 10 | 50 | $60 | $3.6K |
Showing 1–10 of 12
Other providers in the same ZIP code as Geib, Elston, Frost Professional Association, ranked by combined Medicare and Medicaid revenue.
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