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NPI 1619040284 · Pittsburgh, PA · Clinical Medical Laboratory
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Quest Diagnostics Venture LLC is a clinical medical laboratory provider located in Pittsburgh, Pennsylvania. This profile covers 405 Medicare and 329 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 | Quest Diagnostics Venture LLC |
| Address | 875 Greentree Rd |
| City | Pittsburgh |
| State | PA |
| ZIP | 15220 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $96M |
| Medicare | $7.2M |
QUEST DIAGNOSTICS VENTURE LLC reports materially different payer volumes: total Medicare revenue $7.2M versus total Medicaid revenue $96M, indicating Medicaid is the dominant source of billed revenue for this NPI. The record therefore reflects an operation that is heavily weighted toward state payer contracts and Medicaid-covered testing services rather than a Medicare-centric practice.
The provider’s Medicaid billing is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 70.0% of this provider's total Medicaid revenue, led by 80307 ($26.4M, 432.8K claims) and G0480 ($23.5M, 372.2K claims). Both 80307 and G0480 are labeled as extreme outlier volumes in-state and are drug-testing modalities (presumptive and definitive), which signals that a major portion of Medicaid revenue is driven by high-volume toxicology testing services.
On the Medicare side, the top clinical lab codes emphasize routine panels and specimen collection: 80053 ($589.4K), 36415 ($564.5K), and 84443 ($450.4K) are among the highest-revenue CPTs billed. The dataset notes that the precomputed top 3 Medicare codes by revenue account for 32.1% of this provider's total Medicare revenue, indicating that routine chemistry panels, phlebotomy, and TSH testing are principal Medicare revenue drivers.
Competitive standing versus peers is pronounced in both payers: for Medicare the provider ranks at or near the 100th percentile on several high-volume codes (80053 ranks #61 of 26416 — 100th percentile; 36415 ranks #56 of 86467 — 100th percentile), described as extreme outlier volumes nationally. This pattern indicates the entity functions at a national-scale level for common lab testing on Medicare claims rather than as a modest local lab.
State-level dominance is even clearer in Medicaid: G0480 ranks #1 of 132 in-state (100th percentile; extreme outlier) and 80307 ranks #4 of 210 in-state (99th percentile; extreme outlier), while multiple STI and infectious disease testing codes (U0003, 87491, 87591) also appear as extreme outliers in-state. Those ranks and labels support a conclusion that the provider is a leading Medicaid laboratory within Pennsylvania for drug testing, high-throughput SARS-CoV-2 testing, and sexually transmitted infection screening.
The raw claim volumes reinforce a high-throughput, centralized laboratory model: Medicare shows very large claim counts for specimen and panel codes (e.g., 36415 with 70.6K claims and 80053 with 58.9K claims) while Medicaid claim volumes are even larger for target services (80307 432.8K claims; G0480 372.2K claims; U0003 81.6K claims). These claim-level totals are consistent with a laboratory that processes high specimen volumes and likely serves wide referral networks or collection programs rather than a small outpatient clinic lab.
Revenue mix and concentration pose business implications: with top 3 Medicaid codes accounting for 70.0% of Medicaid revenue and top 3 Medicare codes accounting for 32.1% of Medicare revenue, the provider’s financial performance is concentrated in a small set of test types (notably drug-testing and routine chemistry/TSH panels). That concentration creates exposure to payer policy, reimbursement changes, or utilization shifts specifically impacting those code groups.
The NPI tenure shows long-term enumeration: the provider NPI was enumerated 2006-11-15 (~20 years ago), indicating an established presence in the market and sufficient duration to build the large claim volumes and payer relationships observed in both Medicare and Medicaid datasets.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
405 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. | 58,940 | $10 | $589.4K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 70,560 | $10 | $564.5K |
| 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… | 28,150 | $20 | $450.4K |
| 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. | 33,450 | $10 | $434.9K |
| G0480 | 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… | 3,810 | $110 | $426.9K |
| 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… | 12,050 | $30 | $349.6K |
| 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… | 42,700 | $10 | $341.6K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 4,110 | $60 | $250.4K |
| 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).… | 20,760 | $10 | $207.6K |
| 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. | 3,440 | $40 | $137.5K |
Showing 1–10 of 405
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 405 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
405 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 2 | 10 | 30 | $2,950 | $2.2M |
| 87798 | 35 | 40 | 1,250 | $30 | $1.1M |
| 87799 | 4 | 10 | 790 | $40 | $128.8K |
| 81279 | 4 | 10 | 110 | $180 | $98.5K |
| 81339 | 4 | 10 | 60 | $180 | $97K |
| 87529 | 13 | 10 | 80 | $30 | $96.6K |
| G0480 | 3 | 40 | 270 | $110 | $94.5K |
| 81513 | 3 | 10 | 490 | $140 | $86.1K |
| 87493 | 6 | 10 | 110 | $40 | $79.7K |
| 83521 | 1 | 10 | 4,060 | $20 | $62.6K |
Showing 1–10 of 405
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.
329 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 432,780 | $60 | $26.4M |
| G0480 | 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… | 372,220 | $60 | $23.5M |
| 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… | 81,640 | $80 | $6.1M |
| 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… | 58,570 | $40 | $2.4M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 96,750 | $20 | $2.3M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 94,760 | $20 | $2.2M |
| 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. | 136,440 | $10 | $1.6M |
| 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. | 156,300 | $10 | $1.6M |
| 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… | 45,240 | $30 | $1.4M |
| 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… | 68,440 | $20 | $1.4M |
Showing 1–10 of 329
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
329 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0481 | 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… | 8 | 20 | 710 | $80 | $1.7M |
| G0480 | 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… | 1 | 130 | 310 | $60 | $769.3K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 4 | 210 | 730 | $40 | $689.7K |
| 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,… | 5 | 10 | 1,270 | $340 | $567.5K |
| 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… | 4 | 200 | 990 | $70 | $517.5K |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 8 | 10 | 470 | $260 | $227K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 2 | 10 | 70 | $150 | $154.4K |
| 87633 | The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for… | 33 | 60 | 110 | $220 | $151.2K |
| 87800 | The lab analyst performs a test for multiple infectious organisms in one sample using direct nucleic acid probe technique. | 4 | 10 | 530 | $20 | $139.6K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 2 | 30 | 220 | $30 | $139.6K |
Showing 1–10 of 329
Other providers in the same ZIP code as Quest Diagnostics Venture LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Quest Diagnostics Of Pennsylvania, Inc. | PA | Clinical Medical Laboratory | $11.3M | $132.4M |
| Institute For Dermatopathology, Inc. | PA | Clinical Medical Laboratory | $1.5M | $522.1K |
| Danielle Sharek | PA | Diagnostic Radiology Physician | $170.5K | $2.1K |
| Gautam Patel | PA | Diagnostic Radiology Physician | $70.1K | $6K |
| Philip Galapon | PA | Family Medicine Physician | $72.4K | $0 |
| Magali Fontaine | PA | Clinical Pathology Physician | $14.9K | $0 |
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