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NPI 1659574127 · Memphis, TN · Anatomic Pathology & Clinical Pathology Physician
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Richard Kinsey is a anatomic pathology & clinical pathology physician provider located in Memphis, Tennessee. This profile covers 33 Medicare and 8 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 | Richard Kinsey |
| Address | 3495 Hacks Cross Rd |
| City | Memphis |
| State | TN |
| ZIP | 38125 |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| NPI Enumerated | June 11, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.3M |
| Medicaid | $147.3K |
The provider’s code mix is characteristic of a high-throughput diagnostic pathology practice: dominant codes include 88305 (surgical pathology level IV), 87506 (multiplex nucleic acid testing for GI pathogens), and 88312 (special stains). This combination of high-volume surgical pathology plus substantial molecular/infectious testing and immunohistochemistry/special stains implies a lab-focused operation that handles both routine surgical specimens and multiplex infectious disease assays.
Medicare revenue is highly concentrated: the top 3 Medicare codes by revenue account for 75.8% of the provider’s total Medicare revenue, driven by 88305 (37.9%), 87506 (29.3%), and 88312 (8.5%). That concentration indicates the business is heavily dependent on a small set of pathology and molecular-testing services for the majority of its Medicare receipts.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes by revenue account for 98.6% of the provider’s total Medicaid revenue, with U0003 representing 81.3% and 88305 and U0005 making up most of the remainder (13.6% and 3.6%, respectively). This shows Medicaid billing is dominated by SARS-CoV-2 high-throughput testing (U0003) rather than a broad range of pathology services.
Payer mix is strongly Medicare-weighted: total Medicare revenue is $3.3M versus total Medicaid revenue of $147.3K, so Medicare is the primary commercial driver of this provider’s volumes and revenue. Medicaid activity exists but is small in absolute dollars and concentrated in a few test codes.
On national Medicare competitive standing, this provider is a major outlier for multiple pathology codes: 88305 ranks #19 of 14580 nationally (100th percentile; labeled an extreme outlier) and 88312 ranks #30 of 6966 (100th percentile; extreme outlier), while 87506 ranks #3 of 90 nationally (98th percentile; notably above typical national volume). Those rankings position the provider as a high-volume national participant for core surgical pathology and select molecular infectious tests.
In-state competitive standing for Medicaid services is modest: U0003 (the largest Medicaid revenue code) ranks #22 of 95 in-state (78th percentile; described as typical, unremarkable volume), and 88305 ranks #89 of 201 in-state (56th percentile; typical, unremarkable volume). This indicates the provider is not a dominant Medicaid statewide player despite heavy utilization of COVID testing on the Medicaid side.
Operational scale is reflected in claim counts and breadth of lab services: example volumes include 88305 with 46.4K Medicare claims and 87506 with 3.8K Medicare claims, alongside thousands of claims across immunohistochemistry and special-stain codes (88342, 88313, 88341). Those claim counts are consistent with a centralized, high-throughput pathology laboratory processing large specimen volumes rather than a low-volume consult practice.
The provider shows significant SARS-CoV-2 testing activity across payers: Medicare U0003 appears with 1.2K claims ($90.7K revenue) and Medicaid U0003 with 2.1K claims ($119.4K revenue), while U0005 also appears on both payers. Medicare U0003 ranks #174 of 973 (82nd percentile; typical) and Medicaid U0003 ranks #22 of 95 (78th percentile; typical), indicating COVID-era high-throughput testing is an important but not unusually dominant element of the provider’s Medicare and Medicaid activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
33 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… | 46,410 | $30 | $1.3M |
| 87506 | The lab analyst performs a test to detect six to eleven types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal… | 3,750 | $260 | $968.3K |
| 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… | 4,840 | $60 | $280.6K |
| 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,… | 3,580 | $50 | $168.4K |
| 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,… | 3,140 | $50 | $144.6K |
| 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… | 1,230 | $70 | $90.7K |
| 88120 | The lab analyst performs a technical lab test on a urinary tract specimen using in situ hybridization and three to five molecular probes for manual morphometric analysis, looking at the number and… | 210 | $380 | $79.6K |
| 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… | 1,640 | $40 | $69K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 1,720 | $30 | $46.5K |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 280 | $130 | $36.1K |
Showing 1–10 of 33
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 2,130 | $60 | $119.4K |
| 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… | 910 | $20 | $20K |
| U0005 | 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, cdc or non-cdc,… | 880 | $10 | $5.3K |
| 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… | 70 | $30 | $1.8K |
| 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… | 60 | $10 | $280 |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 50 | $0 | $0 |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 50 | $0 | $0 |
| 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… | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 22 | 100 | 400 | $60 | $524.7K |
| 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… | 89 | 200 | 600 | $30 | $168.3K |
| 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… | 35 | 50 | 180 | $20 | $153.7K |
| U0005 | 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, cdc or non-cdc,… | 21 | 50 | 540 | $20 | $152.7K |
| 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… | 24 | 40 | 140 | $150 | $140K |
| 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… | 37 | 60 | 120 | $30 | $37.9K |
| 87581 | The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique. | 17 | 20 | 110 | $20 | $22.6K |
| 87486 | The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild… | 16 | 20 | 100 | $20 | $17.9K |
Other providers in the same ZIP code as Richard Kinsey, ranked by combined Medicare and Medicaid revenue.
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