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NPI 1669484473 · Salt Lake City, UT · Clinical Medical Laboratory
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Myriad Genetic Laboratories, Inc. is a clinical medical laboratory provider located in Salt Lake City, Utah. This profile covers 7 Medicare and 34 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 | Myriad Genetic Laboratories, Inc. |
| Address | 322 N 2200 W |
| City | Salt Lake City |
| State | UT |
| ZIP | 84116 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $124.8M |
| Medicare | $65.9M |
MYRIAD GENETIC LABORATORIES, INC. has an NPI enumerated on 2006-08-12 (~20 years ago), indicating long tenure as a clinical medical laboratory. That longevity aligns with concentrated, specialized testing lines rather than a new market entrant profile.
The provider’s Medicaid revenue ($124.8M) is roughly double its Medicare revenue ($65.9M), indicating Medicaid is the larger payer relationship in absolute scale for this lab. Both payers are material to the business, but Medicaid represents the dominant single-payer revenue stream on the record.
Medicare revenue is extremely concentrated: the precomputed top-3 Medicare codes account for 97.5% of this provider’s total Medicare revenue, driven by 81541 ($32.6M, 49.5% of Medicare revenue), 81479 ($28.8M, 43.7%), and 0172U ($2.9M, 4.4%). This mix shows a heavy reliance on high-value molecular diagnostics and proprietary laboratory analyses rather than a broad menu of routine lab tests.
Medicaid revenue is also concentrated, with the top-3 Medicaid codes accounting for 74.9% of total Medicaid revenue; those top contributors are 81162 ($71.9M, 57.7% of Medicaid revenue), 81479 ($11.2M, 9.0%), and 81211 ($10.2M, 8.2%). The Medicaid book of business is dominated by BRCA sequencing and related hereditary cancer testing services as the core revenue drivers.
On competitive standing in Medicare, 81479 ranks #6 of 80 nationally and is described as notably above typical national volume (94th percentile), while 81541 and 0172U each rank #1 of 1 nationally (0th percentile; no national peer volume comparison available). Additionally, 88381 appears as an extreme outlier (rank #3 of 224, 99th percentile), signaling unusually high volume for manual microdissection relative to national peers. Together these signals indicate national leadership in several proprietary or high-complexity molecular tests and outsized utilization in select pathology procedures.
In-state Medicaid comparisons show clear market dominance for many hereditary testing codes: 81162, 81211, 81406 and numerous other genetic sequencing and deletion/duplication codes rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available). 81479 ranks #1 of 4 in-state (100th percentile; typical, unremarkable volume), which together imply the lab is the primary in-state source for many BRCA and hereditary cancer assays.
The code mix — high revenue from 81541 (mRNA expression profiling), 0172U (myChoice® CDx PLA), and large volumes of BRCA sequencing under 81162 — indicates the lab’s service lines focus on oncology companion diagnostics, hereditary cancer testing, and algorithmic/multianalyte assays. This profile suggests commercial specialization in precision oncology and hereditary risk assessment rather than general clinical laboratory services.
Operational sensitivity is apparent because a handful of specific codes generate most revenue: top-3 Medicare codes produce 97.5% of Medicare revenue and top-3 Medicaid codes produce 74.9% of Medicaid revenue. That concentration, combined with several codes noted as deleted or sunsetted in the file (for example 81433 and the warning on 81436), suggests the provider’s revenue could be disproportionately affected by changes to a small number of molecular pathology coverage or coding rules.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81541 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 46 genes, and carries out an algorithmic analysis using patient data and the lab test results for patients with… | 8,630 | $3,780 | $32.6M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 17,150 | $1,680 | $28.8M |
| 0172U | 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 0172U for the… | 980 | $2,960 | $2.9M |
| 88381 | A clinician, typically a pathologist, performs a manual microdissection of a patient’s specimen, such as a biopsy or tissue preserved from a previous case. | 7,700 | $150 | $1.1M |
| 81522 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 12 genes and carries out an algorithmic analysis using patient data and the lab–test results to report a risk… | 90 | $3,800 | $341.6K |
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 110 | $1,630 | $174.2K |
| 88360 | The lab analyst applies a 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, evaluates the… | 120 | $90 | $10.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
34 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 80,460 | $890 | $71.9M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 88,090 | $130 | $11.2M |
| 81211 | N/A | 9,380 | $1,090 | $10.2M |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 72,490 | $120 | $9M |
| 81307 | The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene. | 49,080 | $100 | $5.1M |
| 81213 | N/A | 9,780 | $220 | $2.2M |
| 81292 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutL homolog 1, or MLH1 gene, also known as the colon cancer or nonpolyposis type 2 gene. | 6,970 | $300 | $2.1M |
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 6,820 | $280 | $1.9M |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 6,850 | $210 | $1.5M |
| 81541 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 46 genes, and carries out an algorithmic analysis using patient data and the lab test results for patients with… | 3,000 | $460 | $1.4M |
Showing 1–10 of 34
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
34 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81162 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the BRCA1, DNA repair–associated gene, also called BRCA1; and BRCA2, DNA repair–associated gene, also called… | 1 | 10 | 80,460 | $890 | $71.9M |
| 81211 | N/A | 1 | 10 | 9,380 | $1,090 | $10.2M |
| 81406 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 7 molecular pathology code. | 1 | 10 | 72,490 | $120 | $9M |
| 81307 | The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene. | 1 | 10 | 49,080 | $100 | $5.1M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 1 | 10 | 550 | $130 | $2.8M |
| 81213 | N/A | 1 | 10 | 9,780 | $220 | $2.2M |
| 81292 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutL homolog 1, or MLH1 gene, also known as the colon cancer or nonpolyposis type 2 gene. | 1 | 10 | 6,970 | $300 | $2.1M |
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 1 | 10 | 6,820 | $280 | $1.9M |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 1 | 10 | 6,850 | $210 | $1.5M |
| 81541 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 46 genes, and carries out an algorithmic analysis using patient data and the lab test results for patients with… | 1 | 10 | 3,000 | $450 | $1.4M |
Showing 1–10 of 34
Other providers in the same ZIP code as Myriad Genetic Laboratories, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| First Step House | UT | Substance Abuse Rehabilitation Facility | $0 | $46.1M |
| Ihc Health Services Inc | UT | Air Ambulance | $2.8M | $10.4M |
| Red Rock Medical Supply | UT | Durable Medical Equipment & Medical Supplies | $0 | $7.3M |
| Rose Park Pediatric Dentistry, PC | UT | Pediatric Dentistry | $0 | $1.8M |
| Community Health Centers, Inc. | UT | Federally Qualified Health Center (FQHC) | $0 | $1.1M |
| Treagan White | UT | Pediatric Dentistry | $0 | $614.1K |
| Health Clinics Of Utah-slc | UT | Family Nurse Practitioner | $0 | $609.8K |
| Your Home Clinic Company | UT | Gerontology Nurse Practitioner | $0 | $338.1K |
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