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NPI 1639713787 · De Soto, KS · Clinical Medical Laboratory
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Biodesix, Inc. is a clinical medical laboratory provider located in De Soto, Kansas. This profile covers 2 Medicare and 3 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 | Biodesix, Inc. |
| Address | 8960 Commerce Dr Bldg 6 |
| City | De Soto |
| State | KS |
| ZIP | 66018 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 1, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $16.8M |
| Medicaid | $1M |
BIODESIX, INC. is operating as a clinical medical laboratory based in DE SOTO, KS (NPI enumerated 2019-11-01 (~7 years ago)), and its Medicare and Medicaid billing is dominated by proprietary PLA laboratory assays targeted at lung-nodule risk stratification. The two PLA codes reported for Medicare, 0080U and 0360U, correspond to the BDX–XL2 and Nodify CDT® assays respectively, which indicates the provider’s service line centers on commercial, algorithm-driven diagnostic tests rather than routine anatomic pathology or general clinical chemistry panels.
Revenue concentration on Medicare is extremely focused: total Medicare revenue is $16.8M, and the precomputed top 3 Medicare codes account for 100.0% of that Medicare revenue. Within that, 0080U alone represents 79.7% of Medicare revenue and 0360U represents 20.3%, making these two proprietary assays the sole drivers of the provider’s Medicare receipts in the dataset.
Medicaid billing is similarly concentrated but much smaller in scale: total Medicaid revenue is $1M and the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue. On the Medicaid side 0080U drives 83.4% of the Medicaid revenue, 0360U drives 15.5%, and 81599 contributes the remaining 1.1%, showing the same product mix but a much lower absolute Medicaid footprint compared with Medicare.
Payer mix skews heavily to Medicare in absolute scale: the provider reports $16.8M in Medicare revenue versus $1M in Medicaid revenue, making Medicare the dominant payer by an order of magnitude. While the same proprietary tests appear on both payers, BIODESIX functions effectively as a Medicare-focused revenue generator with only a modest Medicaid presence.
Competitive standing for these PLA assays is singular in the available data: for Medicare both 0080U and 0360U are listed as rank #1 of 1 providers nationally with a 0th percentile and "no national peer volume comparison available," and for Medicaid those codes are rank #1 of 1 in-state with a 0th percentile and "no state peer volume comparison available." This pattern indicates BIODESIX is the sole or primary reporter of these manufacturer-specific PLA codes in the dataset rather than competing across many labs.
Payment rate differentials across payers are notable and consistent with high-cost proprietary assays: for 0080U the average paid/claim is $3442 on Medicare versus $504 on Medicaid, and for 0360U it is $636 on Medicare versus $88 on Medicaid. Those per-claim payment gaps underscore substantial differences in reimbursement levels between Medicare and Medicaid for the same PLA services and help explain a large portion of the Medicare revenue concentration.
The distribution of claims volume supports a business model built on mid-to-high per-claim pricing for proprietary tests: Medicare counts for 0080U show 3.9K claims at $3442 avg paid/claim and 0360U shows 5.4K claims at $636 avg paid/claim, while Medicaid shows 1.7K claims for 0080U and 1.8K claims for 0360U at lower average payments. This volume-plus-price mix indicates a repeatable, proprietary-test revenue stream rather than fragmented, low-margin panel testing.
The presence of 81599 on the Medicaid ledger (281 claims, $39 avg paid/claim, $11K revenue) is small but notable: it suggests occasional use of non-specific MAAA coding on Medicaid that does not materially affect the provider’s overall revenue profile. Overall, BIODESIX’s financial footprint in the claims data is narrowly concentrated on proprietary lung-nodule assays with dominant Medicare exposure and a unique, non-comparative position in the available peer 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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 0080U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0080U for the… | 3,880 | $3,440 | $13.4M |
| 0360U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0360U only for… | 5,370 | $640 | $3.4M |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 0080U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0080U for the… | 1,670 | $500 | $840.2K |
| 0360U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0360U only for… | 1,780 | $90 | $156.4K |
| 81599 | Use 81599 to report a multianalyte assay with algorithmic analysis, or MAAA test, that does not have a specific Category I code or an administrative code in Appendix O. | 280 | $40 | $11K |
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 0080U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0080U for the… | 1 | 10 | 1,670 | $500 | $840.2K |
| 0360U | This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0360U only for… | 1 | 10 | 1,780 | $90 | $155.8K |
| 81599 | Use 81599 to report a multianalyte assay with algorithmic analysis, or MAAA test, that does not have a specific Category I code or an administrative code in Appendix O. | 1 | 10 | 280 | $40 | $11K |
Other providers in the same ZIP code as Biodesix, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Hillside Village, LLC | KS | Skilled Nursing Facility | $0 | $1.8M |
| Desoto Usd 232 | KS | Local Education Agency (LEA) | $0 | $872.1K |
| Nana Asante | KS | Family Nurse Practitioner | $25.2K | $0 |
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