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NPI 1679618359 · Baltimore, MD · Clinical Pathology/Laboratory Medicine Physician
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St Paul Place Specialists, Inc. is a clinical pathology/laboratory medicine physician provider located in Baltimore, Maryland. This profile covers 254 Medicare and 21 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 | St Paul Place Specialists, Inc. |
| Address | 301 Saint Paul St |
| City | Baltimore |
| State | MD |
| ZIP | 21202 |
| Taxonomy | Clinical Pathology/Laboratory Medicine Physician |
| NPI Enumerated | February 21, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.7M |
| Medicaid | $948.8K |
ST PAUL PLACE SPECIALISTS, INC. presents a classic clinical pathology/laboratory medicine profile: the Medicare CPT mix is dominated by high-volume routine chemistry and hematology panels (examples include 80053, 80061, 85025, 83036 and 84443) while both payers show substantial utilization of molecular infectious-disease assays (notably 0241U and U0003). This blend of high-volume routine testing plus high-revenue molecular codes is consistent with a laboratory operation that processes large volumes of outpatient specimens and runs high-throughput PCR/NAAT workflows.
Medicare revenue is concentrated in a small set of routine lab codes: 80053 (15.4% of Medicare revenue), 80061 (12.3%), and 84443 (10.3%) together account for 38.0% of the provider’s total Medicare revenue. That concentration in common panels and endocrine tests indicates that a handful of frequently ordered assays drive a meaningful share of the Medicare business.
Medicaid revenue is extremely concentrated in SARS-CoV-2 and high-revenue molecular testing: U0003 (66.8% of Medicaid revenue), 0241U (15.0%), and 87635 (14.4%) together account for 96.2% of the provider’s total Medicaid revenue. This indicates the provider’s Medicaid activity is overwhelmingly driven by COVID-related NAAT and a single high-reimbursement molecular assay.
On payer mix, the provider reports Total Medicare revenue: $2.7M and Total Medicaid revenue: $948.8K, so Medicare represents the larger revenue stream while Medicaid is a meaningful but smaller contributor. Analysts should treat Medicare as the primary commercial scale for ongoing lab volume while Medicaid is heavily skewed toward pandemic-era molecular testing.
Nationally for Medicare, the provider ranks at very high volume percentiles on multiple routine codes: 80053 ranks #93 of 26416 (100th percentile; notably above typical national volume for this code), 80061 ranks #98 of 21671 (100th percentile), and 85025 ranks #116 of 32833 (100th percentile; notably above typical national volume for this code). These rank/percentile signals denote a major national presence for common chemistry and hematology assays rather than being a low-volume local supplier.
In-state competitive standing for Medicaid shows the provider as a significant contributor to COVID testing: U0003 ranks #14 of 83 providers in-state (84th percentile) and 87635 ranks #9 of 203 providers in-state (96th percentile). 0241U also ranks highly in-state (#9 of 65, 88th percentile), which together indicate the provider is among the leading Medicaid submitters in Maryland for high-volume/molecular COVID-era testing.
There is an identifiable statistical outlier in the Medicare mix: 0241U is listed as an “extreme outlier” (693 claims, $97K revenue) and ranks #10 of 2910 providers nationally (100th percentile). That single high-revenue molecular code stands out from the routine panel portfolio and suggests either a specialized assay the lab performs at scale or a billing concentration around a particular proprietary or novel test.
Tenure and operational signal: the provider’s NPI was enumerated 2007-02-21 (~19 years ago), indicating an established operating history. Combined with the long tenure and the observed code mix (high national percentiles for routine panels plus outsized molecular testing volumes), this supports an operational profile of a mature, high-throughput laboratory capable of both routine diagnostic panels and large-scale molecular testing.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
254 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 31,760 | $10 | $317.6K |
| 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. | 19,540 | $10 | $254K |
| 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… | 13,330 | $20 | $213.2K |
| 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… | 6,510 | $30 | $188.7K |
| 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… | 22,440 | $10 | $179.5K |
| 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).… | 13,580 | $10 | $135.8K |
| 0241U | N/A | 690 | $140 | $97K |
| 82728 | The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute… | 4,670 | $10 | $60.8K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 6,620 | $10 | $59.5K |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 2,950 | $20 | $59.1K |
Showing 1–10 of 254
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 254 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
254 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 83704 | 2 | 10 | 3,060 | $30 | $102.5K |
| 88120 | 8 | 10 | 70 | $460 | $64.3K |
| 87481 | 23 | 60 | 160 | $30 | $48.7K |
| 87536 | 5 | 10 | 110 | $80 | $48.1K |
| 82024 | 3 | 10 | 150 | $40 | $46.6K |
| G0472 | 2 | 10 | 980 | $50 | $44.6K |
| 87186 | 5 | 20 | 670 | $10 | $39.6K |
| 83970 | 3 | 30 | 30 | $40 | $36.3K |
| 88313 | 128 | 140 | 70 | $60 | $29.4K |
| G0480 | 29 | 30 | 80 | $110 | $29.3K |
Showing 1–10 of 254
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.
21 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… | 8,560 | $70 | $633.4K |
| 0241U | N/A | 1,530 | $90 | $141.8K |
| 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… | 3,260 | $40 | $137K |
| 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,… | 4,300 | $1 | $17.2K |
| 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. | 1,490 | $1 | $5.9K |
| 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… | 1,260 | $1 | $5K |
| 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… | 10 | $100 | $1.3K |
| 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… | 240 | $10 | $1.2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 40 | $30 | $910 |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 40 | $30 | $910 |
Showing 1–10 of 21
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
21 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… | 14 | 80 | 500 | $70 | $691.2K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 45 | 50 | 660 | $30 | $289.2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 46 | 50 | 640 | $30 | $284.4K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 28 | 30 | 1,010 | $20 | $152.5K |
| 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… | 28 | 30 | 60 | $250 | $122.1K |
| 86780 | The lab analyst performs an immunoassay to evaluate the patient’s serum for antibodies to Treponema pallidum, a spiral shaped bacteria called a spirochete, that causes syphilis. | 16 | 20 | 550 | $10 | $99.5K |
| 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. | 46 | 90 | 240 | $10 | $88.5K |
| 0241U | N/A | 9 | 70 | 250 | $90 | $85.2K |
| 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… | 50 | 90 | 370 | $10 | $83.1K |
| 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. | 77 | 120 | 3,170 | $10 | $69.6K |
Showing 1–10 of 21
Other providers in the same ZIP code as St Paul Place Specialists, Inc., ranked by combined Medicare and Medicaid revenue.
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