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NPI 1578726717 · Manitowoc, WI · Dermatopathology (Pathology) Physician
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Kelli Hutchens is a dermatopathology (pathology) physician provider located in Manitowoc, Wisconsin. This profile covers 8 Medicare and 2 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 | Individual |
| Organization | Kelli Hutchens |
| Address | 801 York St |
| City | Manitowoc |
| State | WI |
| ZIP | 54220 |
| Taxonomy | Dermatopathology (Pathology) Physician |
| NPI Enumerated | July 8, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $23.6K |
KELLI HUTCHENS is a dermatopathology (pathology) physician based in MANITOWOC, WI, with an NPI enumerated on 2008-07-08 (~18 years ago), indicating long-standing enrollment in federal programs and sustained activity in diagnostic pathology over nearly two decades. The taxonomy and tenure align with a specialized diagnostic practice rather than a broad multispecialty outpatient clinic.
This provider is effectively Medicare-driven: total Medicare revenue is $1.7M versus total Medicaid revenue of $23.6K, so Medicare accounts for the overwhelming share of billings and economic scale. Medicaid activity exists but is minor in absolute dollars relative to Medicare.
Medicare revenue is highly concentrated in a small set of codes: the precomputed top 3 Medicare codes account for 93.2% of Medicare revenue, driven primarily by 88305 (77.0%), 88342 (10.0%), and 88341 (6.3%). Those three codes together dominate the revenue profile and reflect the providers core diagnostic services.
The code mix points to a high-volume surgical pathology and immunohistochemistry service line: 88305 (level IV surgical pathology) is the single largest driver, while 88342 and 88341 are immunohistochemistry staining and interpretation codes. This combination is characteristic of a dermatopathology-focused diagnostic practice that performs complex slide interpretation and IHC support for tumor/skin lesion characterization.
On national competitive standing for Medicare, this provider is a volume outlier for core codes: 88305 ranks #24 of 14580 (100th percentile; extreme outlier, far above typical national volume for this code) and 88342 ranks #57 of 11370 (100th percentile; extreme outlier, far above typical national volume for this code), while 88341 ranks #91 of 10274 (99th percentile; notably above typical national volume for this code). Those ranks indicate unusually high throughput nationally on these specific pathology services.
Medicaid billing is nearly entirely concentrated in 88305 (722 claims, $23.1K revenue, 99.2% of this provider's total Medicaid revenue) with only a de minimis contribution from 85025 (16 claims, $176 revenue). In-state competitive standing on Medicaid is modest: 88305 ranks #105 of 194 providers in-state (46th percentile; typical, unremarkable volume), so the provider is not a dominant Medicaid pathology vendor within Wisconsin.
Additional Medicare codes show breadth across surgical pathology levels and ancillary stains but at much smaller shares: 88304 contributes $36.5K (2.1% of Medicare revenue) and ranks #22 of 8796 (100th percentile; extreme outlier, far above typical national volume for this code), while technical stain and immunofluorescence codes such as 88312, 88313, and 88350 appear with smaller revenues and are labeled as typical or unremarkable volumes. This pattern suggests the practice reads a wide range of specimen complexities but concentrates revenue in higher-level reads and IHC.
The overall financial and operational profile—heavy reliance on a few high-volume pathology codes and Medicare as the primary payer—implies sensitivity to utilization or reimbursement changes for 88305/88342/88341. Given that the top 3 Medicare codes account for 93.2% of Medicare revenue and the top 3 Medicaid codes account for 100.0% of Medicaid revenue, any shifts in referrals, payer mix, or code-level reimbursement could materially affect revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
8 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… | 39,240 | $30 | $1.3M |
| 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,… | 3,150 | $60 | $173.1K |
| 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… | 2,470 | $40 | $108.5K |
| 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… | 1,150 | $60 | $71.5K |
| 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… | 1,460 | $30 | $36.5K |
| 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… | 50 | $90 | $4.2K |
| 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,… | 90 | $50 | $4.2K |
| 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. | 10 | $120 | $1.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.
View: State1 / 2
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.
2 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… | 720 | $30 | $23.1K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 20 | $10 | $180 |
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
2 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… | 105 | 190 | 940 | $20 | $115.2K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 286 | 300 | 3,190 | $10 | $91.3K |
Other providers in the same ZIP code as Kelli Hutchens, ranked by combined Medicare and Medicaid revenue.
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