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NPI 1750368700 · Research Triangle Park, NC · Clinical Medical Laboratory
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Laboratory Corporation Of America Holdings is a clinical medical laboratory provider located in Research Triangle Park, North Carolina. This profile covers 113 Medicare and 373 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 Holdings |
| Address | 1912 Tw Alexander Dr |
| City | Research Triangle Park |
| State | NC |
| ZIP | 27709 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | December 29, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $281.4M |
| Medicare | $3.5M |
This provider is heavily Medicaid‑weighted: reported Medicare revenue is $3.5M while Medicaid revenue is $281.4M, so Medicaid represents the dominant payer relationship on file. The scale difference indicates the provider’s operations are primarily oriented to services reimbursed by Medicaid rather than Medicare.
Revenue concentration is extreme on Medicare: the top 3 Medicare codes by revenue account for 79.3% of this provider's total Medicare revenue, driven by 81479 ($1.7M, 49.5% of Medicare revenue), 88305 ($565.7K, 16.6%), and 81450 ($453.8K, 13.3%). Those three codes show the provider’s Medicare earnings are tightly focused in molecular pathology/genomic panels and select surgical pathology work.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes by revenue account for 85.7% of this provider's total Medicaid revenue, led by 81420 ($132.9M, 49.1%), U0003 ($67.1M, 24.8%), and 81220 ($31.6M, 11.7%). This concentration indicates the Medicaid business is dominated by large-volume prenatal cfDNA testing, high-throughput SARS‑CoV‑2 testing, and cystic fibrosis panel services.
The code mix indicates a centralized, high-volume genomic and specialty testing operation: major Medicaid codes such as 81420 (cfDNA prenatal panel), 81220 (CFTR testing), 81162 (BRCA sequencing), and 82105/86336 (maternal serum markers) are substantial revenue contributors, while Medicare top codes include 81479 and 81450 (molecular pathology/genomic panels) alongside surgical pathology code 88305. Together these patterns are consistent with a clinical reference laboratory that performs large-scale prenatal screening, hereditary/genomic panels, and specialized molecular pathology.
Competitive standing is mixed across payers: on Medicare the provider shows national leadership for certain specialized tests—88305 ranks #200 of 14580 providers nationally (99th percentile; notably above typical national volume) and 81256 ranks #3 of 110 providers nationally (98th percentile; extreme outlier, far above typical national volume)—while other Medicare lines such as 81479 rank at a typical national volume (rank #28 of 80, 66th percentile). This means the provider is a major national player for specific genetic and pathology assays but has a more typical footprint for other Medicare molecular codes.
In the state Medicaid market the provider is effectively a market leader for multiple prenatal and genetic assays: 81420 ranks #1 of 15 providers in-state (100th percentile; extreme outlier, far above typical state volume), 81220 ranks #1 of 26 (100th percentile; extreme outlier), and 82105 ranks #1 of 32 (100th percentile; extreme outlier). U0003 also ranks very highly in-state (#3 of 158, 99th percentile; extreme outlier), underscoring dominant share in both prenatal screening and high‑throughput COVID testing within North Carolina.
High-throughput infectious testing is a clear operational capability: Medicaid U0003 shows 972.5K claims and $67.1M revenue (24.8% of Medicaid revenue) and U0003 also appears on Medicare (90 claims, $6.7K), indicating the lab runs large-scale SARS‑CoV‑2 amplification workflows in addition to genomic offerings. The combination of nearly-million claim counts for U0003 and hundreds of thousands of claims for prenatal panels (e.g., 356.2K claims for 81420) points to centralized processing volumes and automated, high-capacity lab infrastructure.
The provider has an established presence with long tenure: NPI enumerated 2005-12-29 (~21 years ago), supporting continuity in large-scale laboratory services. Given the sustained, concentrated Medicaid revenue base and repeated top-in-state rankings on key prenatal and genetic codes, the entity’s business profile is that of a long-standing reference laboratory focused on prenatal genomics, hereditary testing, and high-throughput infectious disease diagnostics.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
113 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 500 | $3,390 | $1.7M |
| 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… | 12,040 | $50 | $565.7K |
| 81450 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes known to impact… | 610 | $740 | $453.8K |
| 81256 | The lab analyst performs the technical lab test to detect the presence of common changes in the hemochromatosis gene, also known as HFE. | 3,330 | $60 | $213.1K |
| 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… | 1,970 | $80 | $151.6K |
| 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,… | 1,130 | $60 | $69.1K |
| 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… | 830 | $50 | $44.7K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 240 | $140 | $33.9K |
| 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… | 530 | $60 | $33.5K |
| 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,… | 470 | $60 | $26.1K |
Showing 1–10 of 113
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 113 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
113 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 3 | 10 | 880 | $530 | $835.6K |
| U0003 | 8 | 10 | 90 | $70 | $463.6K |
| 81450 | 1 | 10 | 320 | $740 | $234.1K |
| 88185 | 5 | 10 | 1,270 | $20 | $216.1K |
| 81256 | 1 | 10 | 1,000 | $60 | $92.7K |
| 86003 | 28 | 30 | 640 | $10 | $89.2K |
| 86147 | 6 | 10 | 270 | $20 | $83K |
| 86381 | 3 | 10 | 630 | $20 | $76.5K |
| 86235 | 28 | 40 | 160 | $20 | $70.1K |
| 86364 | 6 | 10 | 950 | $10 | $63.6K |
Showing 1–10 of 113
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.
373 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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,… | 356,230 | $370 | $132.9M |
| 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… | 972,530 | $70 | $67.1M |
| 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… | 127,480 | $250 | $31.6M |
| 82105 | The lab analyst measures the quantitative level of the alpha–fetoprotein. This glycoprotein is produced early in fetal life, and a variety of tumors can also produce it later in life. | 742,370 | $10 | $8.2M |
| 82677 | The lab analyst measures the level of estriol, a weak estrogen hormone, which is usually in high concentrations only during pregnancy. | 290,870 | $20 | $4.7M |
| 86336 | The lab analyst performs a test to identify the levels of inhibin A, typically in a pregnant patient’s serum, to determine the risk for Down syndrome in the fetus. The specimen is blood which the lab… | 323,720 | $10 | $3.9M |
| 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,… | 300,600 | $10 | $3.3M |
| 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… | 5,900 | $540 | $3.2M |
| 84702 | The lab analyst performs the technical lab test to measure the amount of hCG, also known as beta hCG, in blood to confirm or monitor pregnancy, or to diagnose certain tumors of the testes or ovaries. | 342,070 | $10 | $2.7M |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 4,390 | $540 | $2.3M |
Showing 1–10 of 373
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
373 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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 | 20 | 240 | $400 | $13.6M |
| 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… | 1 | 30 | 170 | $260 | $2.6M |
| 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… | 3 | 160 | 840 | $70 | $2.3M |
| 81229 | The lab analyst performs the technical lab test using comparative genomic hybridization (CGH) microarray, also referred to as chromosomal microarray (CMA) or molecular karyotype performed by… | 2 | 10 | 680 | $480 | $1.9M |
| 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… | 76 | 110 | 1,450 | $110 | $1.7M |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 7 | 40 | 480 | $40 | $1.4M |
| 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… | 10 | 80 | 420 | $30 | $1.2M |
| 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 | 410 | $610 | $1M |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 13 | 40 | 220 | $60 | $920.5K |
| 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… | 5 | 10 | 2,000 | $40 | $905.6K |
Showing 1–10 of 373
Other providers in the same ZIP code as Laboratory Corporation Of America Holdings, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Laboratory Corporation Of America Holdings | NC | Clinical Medical Laboratory | $9.6M | $115.7M |
| Laboratory Corporation Of America Holdings | NC | Clinical Medical Laboratory | $2.7M | $53.2M |
| Integrated Laboratory Solutions | NC | Clinical Medical Laboratory | $51.4K | $563.7K |
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