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NPI 1659900348 · Chantilly, VA · Clinical Medical Laboratory
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Microgen Health, Inc is a clinical medical laboratory provider located in Chantilly, Virginia. This profile covers 38 Medicare and 67 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 | Microgen Health, Inc |
| Address | 14225 Sullyfield Cir Ste E |
| City | Chantilly |
| State | VA |
| ZIP | 20151 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 3, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $4.3M |
| Medicaid | $2.1M |
MICROGEN HEALTH, INC presents a laboratory footprint dominated by amplified nucleic acid probe testing and definitive drug identification. The provider's largest Medicare codes are 87798, 87150 and 87481, which correspond to non-specific amplified nucleic acid infectious-agent testing, organism characterization via amplified probes, and Candida species testing respectively, and Medicare also shows material use of definitive drug-testing codes such as G0483 and G0480, indicating a mixed clinical and forensic/reference lab operation.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes (87798, 87150, 87481) account for 67.8% of this provider's total Medicare revenue. Individually those line items appear as 87798 $1.7M (41.1% of Medicare revenue), 87150 $788.8K (18.6%), and 87481 $342.3K (8.1%), signaling heavy dependence on a small set of nucleic-acid-based assays for Medicare billing.
Medicaid billing is also concentrated in a small number of test families: the precomputed top-3 Medicaid codes account for 62.2% of Medicaid revenue, led by presumptive drug testing 80307 ($536.1K, 25.4%), definitive drug testing G0480 ($510.6K, 24.2%), and broader-panel definitive testing G0481 ($268K, 12.7%). This distribution indicates that drug-screening services are the principal Medicaid revenue drivers for the practice at the state level.
Payer mix shows Medicare scale is larger than Medicaid on file: reported lifetime Medicare revenue is $4.3M versus $2.1M in Medicaid. While both payers are material, Medicare represents the single largest payer relationship and Medicaid supports a substantial complementary volume concentrated in substance-use and definitive drug testing codes.
On national Medicare metrics, MICROGEN is a high-volume participant for core molecular assays: 87798 ranks #38 of 1319 providers (97th percentile) and is described as notably above typical national volume; 87150 ranks #17 of 190 (92th percentile) and 87481 ranks #46 of 1117 (96th percentile). The provider also posts an extreme outlier signal on 87651 (rank #21 of 3530, 99th percentile, labeled an "extreme outlier"), indicating exceptional national throughput for certain rapid amplified-probe pathogen assays relative to peers.
In-state Medicaid standings reflect strong placement in drug-testing panels and some niche assays: 80307 ranks #20 of 174 providers (89th percentile) and G0480 ranks #7 of 95 providers (94th percentile), while certain specialized tests are at or near the top of the state list (87500 ranks #1 of 11, 100th percentile; 87556 ranks #1 of 2, 100th percentile). These placements suggest the provider is among the more prominent Medicaid suppliers for drug-testing and selected amplified-probe tests in Virginia.
The blend of high-volume nucleic acid amplification codes on Medicare (e.g., 87798, 87150, 87481) with strong Medicaid revenue from both presumptive (80307) and definitive multi-class drug testing (G0480, G0481, G0483) implies operational diversification across molecular diagnostics and toxicology services. For payers, this pattern signals a lab that can serve both infectious-disease testing pathways and substance-use testing workflows, which may affect network contracting and utilization-management strategies.
MICROGEN's NPI was enumerated on 2020-04-03 (~6 years ago), indicating relatively recent enrollment but rapid scale-up to the reported lifetime Medicare ($4.3M) and Medicaid ($2.1M) revenues. The combination of short tenure and high percentile rankings on multiple codes suggests the organization scaled diagnostic throughput quickly after enumeration rather than exhibiting only legacy, slow-growth volume.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
38 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 51,200 | $30 | $1.7M |
| 87150 | The lab analyst performs an analysis using amplified DNA or RNA probe technique on a previously isolated and identified organism to categorize the organism more specifically, such as to the taxonomic… | 23,200 | $30 | $788.8K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 10,070 | $30 | $342.3K |
| 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… | 1,190 | $240 | $287.3K |
| 87556 | The lab analyst performs a test for Mycobacterium tuberculosis using amplified nucleic acid probe technique. Mycobacteria tuberculosis are sometimes called acid fast bacteria because of the special… | 3,450 | $40 | $141.5K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 4,080 | $30 | $138.7K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 3,900 | $30 | $132.7K |
| 87651 | The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat. | 3,560 | $30 | $121K |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 210 | $430 | $87.9K |
| 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. | 1,400 | $60 | $85.6K |
Showing 1–10 of 38
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 38 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
38 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87150 | 2 | 10 | 470 | $30 | $406.4K |
| 87798 | 2 | 30 | 690 | $30 | $159.2K |
| 81226 | 1 | 10 | 210 | $430 | $87.9K |
| G0482 | 4 | 10 | 60 | $190 | $80.8K |
| 87556 | 1 | 10 | 1,750 | $40 | $71.3K |
| G0483 | 1 | 10 | 110 | $240 | $67.6K |
| 87481 | 2 | 20 | 200 | $30 | $59K |
| 81225 | 1 | 10 | 120 | $280 | $31.7K |
| G0480 | 6 | 10 | 140 | $110 | $23.5K |
| 81227 | 1 | 10 | 130 | $170 | $21.9K |
Showing 1–10 of 38
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
67 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. | 19,860 | $30 | $536.1K |
| 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… | 15,020 | $30 | $510.6K |
| 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… | 4,060 | $70 | $268K |
| 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… | 4,340 | $40 | $177.8K |
| 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… | 2,760 | $60 | $165.3K |
| 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… | 1,870 | $60 | $108.4K |
| G0482 | 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… | 890 | $90 | $81.1K |
| 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,… | 2,350 | $20 | $44.7K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 3,930 | $10 | $43.2K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,390 | $10 | $33.5K |
Showing 1–10 of 67
How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Virginia median
67 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… | 11 | 20 | 3,960 | $130 | $730.9K |
| G0482 | 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… | 9 | 20 | 1,220 | $110 | $459.9K |
| 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. | 20 | 170 | 3,790 | $40 | $415.2K |
| 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… | 6 | 20 | 1,790 | $70 | $347.5K |
| 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… | 7 | 100 | 2,220 | $40 | $214.2K |
| 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… | 16 | 30 | 3,050 | $30 | $120.8K |
| 87631 | The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,… | 13 | 30 | 190 | $30 | $78.1K |
| 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… | 25 | 30 | 150 | $70 | $69K |
| 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… | 182 | 230 | 300 | $40 | $65.4K |
| 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… | 8 | 60 | 430 | $20 | $62.8K |
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Other providers in the same ZIP code as Microgen Health, Inc, ranked by combined Medicare and Medicaid revenue.
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