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NPI 1760897755 · Houma, LA · Clinical Medical Laboratory
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Physicians Group Laboratories, LLC is a clinical medical laboratory provider located in Houma, Louisiana. This profile covers 63 Medicare and 84 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 | Physicians Group Laboratories, LLC |
| Address | 4752 Highway 311 Ste 112 |
| City | Houma |
| State | LA |
| ZIP | 70360 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 27, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $208.1M |
| Medicare | $886.8K |
PHYSICIANS GROUP LABORATORIES, LLC operates as a molecular-focused clinical laboratory with a clear emphasis on nucleic-acid amplified probe techniques and multiplex panels across both payers. Medicare top CPT/HCPCS in its portfolio include 87798, 87150, and 87637, and Medicaid volumes are dominated by PLA and multiplex respiratory codes such as 0225U and 87633, signaling a test menu weighted toward high-volume infectious disease and respiratory pathogen testing.
Medicare revenue is concentrated: the provider’s top three Medicare codes account for 48.6% of its $886.8K Medicare revenue, led by 87798 ($172.9K), 87150 ($115.4K), and 87637 ($83.9K). This concentration indicates reliance on a relatively small set of molecular and probe-based assays to generate nearly half of Medicare receipts.
Medicaid revenue is even more concentrated in a few high-volume molecular tests: the top three Medicaid codes account for 54.3% of $208.1M in Medicaid revenue, principally 0225U ($42.4M), 87633 ($39M), and 87798 ($27.2M). Those three codes alone form the backbone of the provider’s Medicaid billing and point to a service-line centered on proprietary and multiplex respiratory/infectious testing.
The payer mix is heavily skewed toward Medicaid by scale: reported Medicaid revenue of $208.1M far exceeds Medicare revenue of $886.8K, making this provider effectively Medicaid-dominant in its billing footprint rather than balanced across the two public payers. For analysts, this means state policy, contract terms, and Medicaid network positioning will be the primary levers affecting the provider’s financial performance.
PHYSICIANS GROUP LABORATORIES is a dominant in-state Medicaid player on many specific molecular codes: multiple Medicaid CPT/HCPCS codes (for example 0225U, 87633, and 87798) rank #1 in-state and are labeled as 100th percentile or “extreme outlier,” reflecting volumes far above typical Louisiana peers. This statewide dominance across a broad set of infectious-disease assays suggests substantial local market share and testing capacity for public-health and routine surveillance workflows.
By contrast its national Medicare standing is mixed: for some high-value multiplex assays it reports top-tier national percentiles (for example 87637 is at the 96th percentile nationally), while other high-revenue Medicare codes like 87798 sit in a more typical national range (84th percentile). This pattern indicates strong competence and competitive placement on certain multiplex respiratory tests nationally but a more modest overall Medicare footprint in absolute dollars.
The presence and scale of PLA code 0225U (141.9K Medicaid claims, $299 avg paid/claim, $42.4M revenue) indicates use of a proprietary ePlex Respiratory Pathogen Panel and likely investment in the specific manufacturer platform and associated reagents. High claim counts and high average paid/claim for this PLA are consistent with a tailored, platform-dependent service-line that can command substantial Medicaid revenue when it becomes a primary instrument in state testing pathways.
NPI tenure (enumerated 2014-06-27, ~12 years ago) combined with very large Medicaid claim volumes across many organism-specific tests (examples include 87651 $8.2M, 87481 $8.1M, 87507 $5.9M, and 87561 $6.6M) signals an established operation with significant throughput for infectious-disease, STI, GI, and antimicrobial-resistance assays. For payer or provider contracting teams, these data point to a laboratory with both depth of menu and demonstrated capacity to serve high-volume state programs.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
63 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… | 5,080 | $30 | $172.9K |
| 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… | 3,390 | $30 | $115.4K |
| 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)… | 600 | $140 | $83.9K |
| 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,… | 530 | $140 | $73.8K |
| 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… | 730 | $70 | $52.9K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,360 | $30 | $46.3K |
| 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,… | 720 | $30 | $18K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 460 | $30 | $15.7K |
| 82670 | The lab analyst measures the level of total estradiol, an estrogenic hormone, on a specimen such as blood using a method such as liquid chromatography–tandem mass spectrometry (LC–MS/MS) to evaluate… | 570 | $30 | $15.4K |
| 87506 | The lab analyst performs a test to detect six to eleven types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal… | 60 | $260 | $15.2K |
Showing 1–10 of 63
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 63 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
84 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 0225U | 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 0225U for the… | 141,900 | $300 | $42.4M |
| 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… | 156,090 | $250 | $39M |
| 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… | 532,970 | $50 | $27.2M |
| 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… | 61,200 | $200 | $12.4M |
| 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. | 341,470 | $20 | $8.2M |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 338,760 | $20 | $8.1M |
| 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,… | 331,510 | $20 | $8M |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 330,650 | $20 | $7.9M |
| 87541 | The lab analyst performs a test for the bacteria Legionella pneumophila using amplified nucleic acid probe technique. L. pneumophila can inhabit facility water and air conditioning systems and may… | 293,210 | $20 | $7M |
| 87561 | The lab analyst performs a test for Mycobacterium avium intracellulare, MAI, using amplified nucleic acid probe technique. Mycobacteria are bacteria, sometimes called acid fast bacteria because of… | 265,510 | $30 | $6.6M |
Showing 1–10 of 84
How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Louisiana median
84 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 0225U | 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 0225U for the… | 1 | 10 | 70,960 | $300 | $21.2M |
| 87561 | The lab analyst performs a test for Mycobacterium avium intracellulare, MAI, using amplified nucleic acid probe technique. Mycobacteria are bacteria, sometimes called acid fast bacteria because of… | 1 | 10 | 265,510 | $30 | $6.6M |
| 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… | 1 | 70 | 620 | $230 | $913.4K |
| 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… | 1 | 20 | 490 | $160 | $855.8K |
| 87541 | The lab analyst performs a test for the bacteria Legionella pneumophila using amplified nucleic acid probe technique. L. pneumophila can inhabit facility water and air conditioning systems and may… | 1 | 10 | 350 | $20 | $668.7K |
| 87507 | The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal… | 1 | 10 | 210 | $280 | $667.5K |
| 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… | 4 | 100 | 620 | $40 | $560K |
| 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… | 1 | 90 | 650 | $40 | $404.2K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 1 | 20 | 690 | $20 | $359.2K |
| 87532 | The lab analyst performs a test for Herpes virus 6 using amplified nucleic acid probe technique. Herpes virus 6, also called human herpes virus 6 or HHV6, causes a common childhood rash, roseola, and… | 1 | 10 | 790 | $20 | $289.9K |
Showing 1–10 of 84
Other providers in the same ZIP code as Physicians Group Laboratories, LLC, ranked by combined Medicare and Medicaid revenue.
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