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NPI 1699858373 · Knoxville, TN · Clinical Medical Laboratory
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Laboratory Corporation Of America is a clinical medical laboratory provider located in Knoxville, Tennessee. This profile covers 301 Medicare and 308 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 | Laboratory Corporation Of America |
| Address | 1924 Alcoa Hwy |
| City | Knoxville |
| State | TN |
| ZIP | 37920 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $19.8M |
| Medicare | $5.2M |
This entity reports a much larger Medicaid footprint than Medicare, with total Medicaid revenue of $19.8M versus total Medicare revenue of $5.2M, and its top three Medicaid codes together account for 38.5% of Medicaid revenue while the top three Medicare codes account for 34.6% of Medicare revenue. That split indicates the provider’s commercial scale and sensitivity to state-level program volume are materially greater than to Medicare volume.
The code mix reflects a full–service clinical laboratory with heavy throughput in routine chemistry and specimen collection: Medicare top codes include 80053 (48.8K claims, $487.5K revenue), 84443 (28.7K claims, $459.1K revenue), and 36415 (54.2K claims, $433.6K revenue). These volumes suggest integrated specimen collection plus high-volume analytic processing focused on CMPs, TSH testing, and phlebotomy rather than narrow specialty testing alone.
On Medicare the provider is a national-volume leader for several routine tests: 80053 ranks #66 of 26416 providers (100th percentile; notably above typical national volume), 84443 ranks #59 of 19722 (100th percentile; notably above typical national volume), and 36415 ranks #68 of 86467 (100th percentile; extreme outlier, far above typical national volume). These percentile positions indicate the provider functions as a major national aggregator for common lab services, not a low-volume local lab.
Medicaid activity highlights a mix of high-volume screening and specialized testing: U0003 (COVID PCR) produced 33.2K claims and $2.3M revenue and ranks #6 of 95 in-state (95th percentile; typical, unremarkable volume), while 81420 (cell-free fetal DNA) generated 6.7K claims and $1.8M revenue and ranks #1 of 4 in-state (100th percentile; typical, unremarkable volume). The coexistence of large-volume molecular diagnostics and specialized prenatal genomics indicates both high-throughput infectious disease capacity and a leadership position in selected higher-value panels.
Within the state Medicaid market the provider is a dominant volume player for several common panels and screens: 80061 (233K claims, $698.9K revenue) ranks #3 of 222 in-state (99th percentile; extreme outlier, far above typical state volume), 82306 (99.1K claims, $693.5K revenue) ranks #3 of 117 (98th percentile; notably above typical state volume), and 85025 (220.1K claims, $660.2K revenue) ranks #5 of 554 (99th percentile; extreme outlier, far above typical state volume). Those positions show the provider captures disproportionate share of routine Medicaid testing volumes across Tennessee.
Revenue concentration is notable at both payers: the precomputed figures show the top three Medicare codes account for 34.6% of Medicare revenue and the top three Medicaid codes account for 38.5% of Medicaid revenue. That level of concentration around a small set of frequently ordered panels and molecular tests means changes in utilization, fee schedules, or prior authorization policy for these codes could have a material impact on near-term revenue.
Operational breadth includes both high-volume specimen services and definitive toxicology: Medicaid shows very large activity in specimen-collection and screening (36415 with 114.9K claims, 87086 with 134.7K claims) plus definitive drug testing lines (G0481 with 7.6K claims, G0483 with 3.8K claims), and the Medicare list also includes many high-percentile volumes for basic panels and analytes. This combination of phlebotomy, high-throughput PCR/genomic testing, and confirmatory toxicology positions the provider to serve broad payer test mixes and high specimen throughput workflows.
The provider has an established enumeration date of 2006-10-24 (~20 years ago) and the combination of long tenure with the reported scale (Medicare $5.2M; Medicaid $19.8M) and high-percentile ranks—including #1 in-state ranking on 81420—supports characterization as a mature regional operator with niche leadership in some high-value testing areas while also being a dominant volume provider for routine Medicaid 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.
301 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. | 48,750 | $10 | $487.5K |
| 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… | 28,700 | $20 | $459.1K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 54,200 | $10 | $433.6K |
| 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. | 32,370 | $10 | $420.8K |
| 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… | 11,280 | $30 | $327.2K |
| 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… | 36,410 | $10 | $291.3K |
| 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).… | 21,600 | $10 | $216K |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 3,810 | $40 | $152.2K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 14,680 | $10 | $117.4K |
| 82607 | The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood. | 7,640 | $20 | $114.6K |
Showing 1–10 of 301
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 301 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
301 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 5 | 10 | 180 | $930 | $692.4K |
| G0483 | 57 | 70 | 120 | $240 | $181.5K |
| G0481 | 27 | 60 | 80 | $150 | $73.2K |
| 86480 | 2 | 10 | 920 | $60 | $55.7K |
| 88305 | 232 | 420 | 500 | $30 | $55.1K |
| 86003 | 3 | 10 | 9,380 | $10 | $53.7K |
| 81490 | 1 | 10 | 40 | $820 | $35.4K |
| U0003 | 6 | 30 | 20 | $70 | $34.7K |
| 80307 | 42 | 250 | 140 | $60 | $30.1K |
| G0480 | 25 | 70 | 80 | $110 | $29.1K |
Showing 1–10 of 301
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.
308 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… | 33,170 | $70 | $2.3M |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 6,680 | $270 | $1.8M |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 99,280 | $10 | $1.4M |
| 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. | 25,580 | $30 | $741.7K |
| 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. | 232,970 | $1 | $698.9K |
| 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… | 99,080 | $10 | $693.5K |
| 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… | 220,060 | $1 | $660.2K |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 3,110 | $200 | $606.6K |
| 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. | 254,610 | $1 | $509.2K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 43,110 | $10 | $474.2K |
Showing 1–10 of 308
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
308 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 3 | 10 | 13,370 | $40 | $1.1M |
| 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… | 42 | 60 | 430 | $50 | $1M |
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 1 | 10 | 3,970 | $220 | $843K |
| 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… | 14 | 60 | 840 | $60 | $705.4K |
| 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… | 3 | 70 | 180 | $60 | $589.9K |
| 0202U | 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 0202U for the… | 7 | 20 | 1,060 | $210 | $535.6K |
| 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… | 6 | 100 | 400 | $60 | $524.7K |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 3 | 10 | 210 | $200 | $285.2K |
| 87661 | The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique. | 5 | 30 | 480 | $20 | $283.4K |
| 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. | 11 | 240 | 840 | $20 | $259.2K |
Showing 1–10 of 308
Other providers in the same ZIP code as Laboratory Corporation Of America, ranked by combined Medicare and Medicaid revenue.
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