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NPI 1598747651 · Englewood, CO · Clinical Medical Laboratory
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Laboratory Corporation Of America is a clinical medical laboratory provider located in Englewood, Colorado. This profile covers 416 Medicare and 275 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 | Laboratory Corporation Of America |
| Address | 8490 Upland Drive |
| City | Englewood |
| State | CO |
| ZIP | 80112 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 15, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $77.8M |
| Medicare | $14.9M |
This provider is effectively Medicaid‑dominant in scale: reported lifetime Medicaid revenue is $77.8M compared with $14.9M in Medicare, indicating the bulk of its public‑payer billing flows through state Medicaid rather than Medicare. The difference in scale suggests contracting, collections, and operational focus are likely oriented to Medicaid volumes and state payor relationships.
Medicare revenue is concentrated: the top three Medicare codes 80053 ($1.4M, 12.0%), 36415 ($1.3M, 11.5%), and 84443 ($1.3M, 11.3%) together account for 34.9% of this provider's Medicare revenue. Those three codes are routine chemistry and phlebotomy services, so a relatively small set of high‑volume tests drive a large share of Medicare reimbursement.
Medicaid revenue is also concentrated in a small set of high‑volume panels and analytes: codes 80050 ($10.5M, 18.4%), 82306 ($6.3M, 11.0%), and 80061 ($5.3M, 9.3%) together account for 38.8% of Medicaid revenue. The dominance of panel codes (80050, 80061) plus vitamin D testing (82306) indicates Medicaid billing is driven by packaged screening/panel orders at scale.
The CPT/HCPCS mix signals a high‑throughput reference laboratory model: very large volumes on panels (80050, 80053, 80061), phlebotomy (36415), routine endocrinology and screening assays (84443, 82306, 83036, 85025), and culture/susceptibility work (87086, 87186) suggest centralized processing of outpatient specimens and broad service lines from routine chemistry to microbiology. Presence of genomic/complex panels such as 81420 and obstetric panel 80081 on the Medicaid side also point to capacity for higher‑complexity, higher‑reimbursement testing.
National competitive standing on Medicare tests is outsized: many top Medicare codes rank at or near the 100th percentile nationally and are described as "extreme outlier" (for example, 80053 ranks #33 of 26416, 36415 ranks #30 of 86467, and 84443 ranks #31 of 19722). This pattern indicates the provider operates well above typical national volume for a broad set of routine lab codes and functions as a major national contributor for those assays.
State‑level dominance on Medicaid is clear: a large number of the highest‑revenue Medicaid codes rank #1 in‑state and are labeled "extreme outlier" (for example, 80050 #1 of 29, 82306 #1 of 91, 80061 #1 of 125, 84443 #1 of 125). That combination of rank and payer concentration identifies the provider as a leading in‑state lab partner for Medicaid programs across both routine panels and specialty tests.
The provider’s portfolio includes both very high‑volume low‑unit‑price testing and selective higher‑unit‑price assays: examples include high‑volume panel claims on Medicaid (80050 $39 avg paid/claim) alongside higher‑paid services such as 81420 ($482 avg paid/claim, $1.1M Medicaid revenue) and 80081 ($59 avg paid/claim, $1.7M Medicaid revenue). This mix suggests diversified revenue streams where throughput of common assays underpins scale while targeted higher‑complexity tests contribute material incremental revenue.
This entity is long‑tenured on the NPI file (enumerated 2005‑11‑15, ~21 years ago) and shows sustained, large‑scale engagement with public payers over time, reporting $14.9M in Medicare revenue and $77.8M in Medicaid revenue during the lifetime covered. The combination of longevity, high volume across many routine codes, and state/national top rankings supports characterization as a large, established clinical laboratory operator rather than a small community lab.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
416 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 136,290 | $10 | $1.4M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 163,320 | $10 | $1.3M |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 80,060 | $20 | $1.3M |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 91,520 | $10 | $1.2M |
| 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… | 122,260 | $10 | $978K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 31,050 | $30 | $900.6K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 62,670 | $10 | $626.7K |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 9,550 | $40 | $382.1K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 19,760 | $20 | $355.6K |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 34,140 | $10 | $273.1K |
Showing 1–10 of 416
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 416 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.
275 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 269,250 | $40 | $10.5M |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 232,030 | $30 | $6.3M |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 442,210 | $10 | $5.3M |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 290,060 | $20 | $4.4M |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 402,700 | $10 | $3.6M |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 384,240 | $10 | $3.5M |
| 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… | 412,600 | $10 | $2.5M |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 121,680 | $20 | $2.4M |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 252,600 | $10 | $1.8M |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 28,950 | $60 | $1.7M |
Showing 1–10 of 275
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
275 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 30 | 40 | 900 | $170 | $1.5M |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 1 | 10 | 230 | $60 | $573.6K |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 1 | 10 | 1,360 | $410 | $563.5K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 1 | 30 | 230 | $40 | $428.1K |
| 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… | 28 | 40 | 110 | $160 | $326K |
| 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… | 35 | 80 | 830 | $70 | $274.8K |
| 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. | 20 | 20 | 590 | $30 | $230.4K |
| 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… | 19 | 20 | 910 | $20 | $206.3K |
| 80074 | The lab analyst performs an acute hepatitis panel; the panel must include tests for hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody. | 1 | 10 | 210 | $40 | $197.5K |
| 80347 | The lab analyst measures the amount of or detects the presence of 13 or more benzodiazepines, which are tranquilizers, in a patient specimen. | 5 | 10 | 940 | $20 | $185.3K |
Showing 1–10 of 275
Other providers in the same ZIP code as Laboratory Corporation Of America, ranked by combined Medicare and Medicaid revenue.
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