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NPI 1619980430 · Cleveland, OH · Clinical Medical Laboratory
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University Hospitals Laboratory Services Foundation is a clinical medical laboratory provider located in Cleveland, Ohio. This profile covers 390 Medicare and 349 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 | University Hospitals Laboratory Services Foundation |
| Address | 11100 Euclid Ave |
| City | Cleveland |
| State | OH |
| ZIP | 44106 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $41.1M |
| Medicare | $8.4M |
Provider operates at much larger scale on Medicaid than Medicare, reporting $41.1M in lifetime Medicaid revenue versus $8.4M in lifetime Medicare revenue; Medicaid represents the dominant payer by dollars and will drive contracting and utilization risk assumptions more heavily than Medicare. This imbalance suggests payer-management and revenue-cycle efforts should prioritize Medicaid rate and volume dynamics.
Medicare revenue is concentrated in routine phlebotomy and core chemistry panels: codes 36415, 80053, and 80061 together account for 35.4% of this provider's total Medicare revenue. Those three codes (36415 at $905.6K, 80053 at $688.6K, 80061 at $643.3K) indicate an operation focused on high-volume specimen collection plus standard outpatient laboratory testing.
Medicaid revenue concentration is driven by high-volume molecular and infectious-disease testing: codes 87635, 87491, and 87591 account for 30.6% of Medicaid revenue and individually represent $3.5M, $2.5M, and $2.5M in revenue respectively. This mix points to significant NAAT capacity for SARS–CoV–2 and routine STI screening as a core Medicaid service line.
The provider’s code mix across both payers indicates a full-service reference laboratory with high-throughput molecular diagnostics, routine chemistry/hematology, drug testing, and immunology panels. Evidence includes large Medicaid volumes for 87635, 87636, U0004 and state-leading claims for STI codes, paired with Medicare volumes for 80053, 85025, 83036, 84443, 82306 and definitive drug testing codes G0480 and 80307.
For Medicare the provider is a national volume outlier on many routine tests: multiple top CPT/HCPCS codes are at the 100th percentile or otherwise labeled “extreme outlier” versus national peers (for example, 36415 ranks #39 of 86467 and 80053 ranks #57 of 26416, both 100th percentile). These national high-percentile positions indicate this facility operates at a scale far above typical providers for core outpatient lab services and will be a major national-volume reference for payers.
State-level competitive standing on Medicaid is dominant for several high-revenue diagnostics: 87635 ranks #1 of 295 providers in-state (100th percentile; extreme outlier) and 86003 ranks #1 of 50 providers in-state (100th percentile). Those #1 ranks and multiple top-5 state placements for NAAT and STI testing demonstrate market leadership in Ohio for molecular infectious-disease testing.
Claim volumes and ranks show very high specimen throughput and centralized collection capacity: Medicare 36415 reports 113.2K claims ($905.6K revenue) and Medicaid 36415 reports 321.6K claims ($964.7K revenue), while Medicaid 87635 reports 81.6K claims ($3.5M revenue). These figures, together with high ranks and extreme-outlier labels, support an operational profile with large-scale phlebotomy and high-throughput lab instrumentation rather than a small hospital lab.
The provider has a long NPI tenure—enumerated 2006-08-14 (~20 years ago)—which, combined with sustained high volumes across both Medicare and Medicaid, suggests established operations and capacity that payers should consider in network design and volume-based contracting discussions.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
390 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 113,190 | $10 | $905.6K |
| 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. | 68,860 | $10 | $688.5K |
| 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. | 49,490 | $10 | $643.3K |
| 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… | 38,870 | $20 | $622K |
| 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… | 19,870 | $30 | $576.1K |
| 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… | 45,530 | $10 | $364.2K |
| 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).… | 27,860 | $10 | $278.6K |
| 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. | 3,560 | $60 | $210.3K |
| 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. | 5,130 | $40 | $205.2K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 12,770 | $20 | $191.6K |
Showing 1–10 of 390
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 390 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.
349 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 81,620 | $40 | $3.5M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 96,080 | $30 | $2.5M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 92,310 | $30 | $2.5M |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 12,730 | $130 | $1.7M |
| 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. | 42,540 | $40 | $1.6M |
| 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… | 147,730 | $10 | $1.5M |
| 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. | 206,760 | $10 | $1.4M |
| 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… | 93,320 | $20 | $1.4M |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 54,870 | $30 | $1.4M |
| 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. | 129,780 | $10 | $1M |
Showing 1–10 of 349
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
349 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81381 | The lab analyst performs the technical lab test for high resolution assessment of human leukocyte antigen genes, called HLA, for one Class I allele or allele group of interest, typically one that is… | 3 | 10 | 1,140 | $40 | $3.4M |
| 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… | 7 | 50 | 220 | $30 | $675.9K |
| 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… | 15 | 20 | 170 | $210 | $485.4K |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 7 | 40 | 230 | $130 | $455.9K |
| 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. | 13 | 340 | 2,260 | $30 | $398.2K |
| 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… | 3 | 140 | 410 | $30 | $384.3K |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 5 | 10 | 710 | $530 | $379.9K |
| 87902 | The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus. | 11 | 20 | 290 | $160 | $379.2K |
| 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. | 7 | 270 | 8,700 | $10 | $353.7K |
| 86480 | The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies. | 22 | 60 | 330 | $40 | $323K |
Showing 1–10 of 349
Other providers in the same ZIP code as University Hospitals Laboratory Services Foundation, ranked by combined Medicare and Medicaid revenue.
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