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NPI 1770734253 · Phoenix, AZ · Clinical Medical Laboratory
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Castle Biosciences, Inc is a clinical medical laboratory provider located in Phoenix, Arizona. This profile covers 9 Medicare and 8 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 | Castle Biosciences, Inc |
| Address | 3737 N 7th St |
| City | Phoenix |
| State | AZ |
| ZIP | 85014 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 2, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $70.9M |
| Medicaid | $1.3M |
CASTLE BIOSCIENCES, INC operates primarily as a proprietary molecular diagnostics laboratory focused on algorithmic mRNA gene-expression tests and select pharmacogenomic assays; its Medicare billing is concentrated in specialized PLA and molecular pathology codes tied to melanoma risk stratification and pharmacogenomics rather than routine clinical lab panels. Total Medicare revenue on file is $70.9M, and the top three Medicare codes (including 81529, 81552, and 0090U) together account for 98.6% of that Medicare revenue, indicating a product-driven, test-specific business model.
Revenue concentration is extreme for Medicare: 81529 alone accounts for $66.1M (93.3% of this provider's total Medicare revenue) with 9.4K claims and a $7049 avg paid/claim, and the precomputed top-3 share of 98.6% shows almost all Medicare dollars flow from a very small set of high-value tests. The Medicaid picture mirrors this concentration at a smaller scale: total Medicaid revenue is $1.3M, 81529 accounts for $1M (80.3% of Medicaid revenue), and the top three Medicaid codes account for 94.5% of Medicaid revenue, so both payers are dominated by the same core assays.
Payer mix is heavily skewed to Medicare by scale: Medicare revenue ($70.9M) dwarfs Medicaid revenue ($1.3M), making this entity effectively a Medicare-driven revenue center in these datasets. That imbalance suggests contract and reimbursement discussions with commercial and Medicare payers will materially affect overall revenue more than state Medicaid relationships.
For competitive standing on proprietary tests, the provider appears to be the sole national reporter: 81529, 81552, and 0090U each "rank #1 of 1 providers nationally (0th percentile; no national peer volume comparison available)," which is consistent with these being manufacturer-specific PLA offerings. In plain terms, Castle Biosciences is the originating/sole source for several high-revenue PLA tests at a national level, giving it de facto market dominance for those specific assays.
For non-PLA molecular and pharmacogenomic codes the provider shows modest participation relative to peers: 81418 (pharmacogenomic panel) is $454.5K in Medicare revenue, ranks #3 of 17 nationally (88th percentile) and is described as typical/expected volume, while 81479 is midpack (rank #42 of 80 nationally, 48th percentile). This mix indicates the lab supplements its proprietary melanoma tests with more commonly coded pharmacogenomic services at levels that are notable but not market-leading.
State-level Medicaid rankings reinforce sole-source provision of several tests in Arizona: 81529, 0411U, 81226, 81225, 0315U and 0090U all "rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available)," indicating Castle is the only in-state reporter for multiple PLA and genetics assays. Where comparisons exist (e.g., 81479 at rank #3 of 4 in-state), volumes are characterized as typical and do not change the dominant role for the proprietary assays.
Tenure and operational footprint are established: the provider's NPI was enumerated on 2008-10-02 (~18 years ago), indicating a long-standing presence in the market which supports proprietary test development and national PLA reporting. That length of enumeration is consistent with a laboratory that has had time to commercialize branded assays and build referral patterns into Medicare billing.
The extreme revenue concentration in a handful of high-priced tests (precomputed top-3 Medicare share 98.6% and top-3 Medicaid share 94.5%) is a strategic and financial vulnerability: payer reimbursement changes, coding updates, or competitive PLA approvals could rapidly affect overall revenue. Analysts should treat the entity as a product-centric lab with dominant single-test revenue streams rather than a diversified clinical lab when modelling reimbursement risk and competitive exposure.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81529 | The lab analyst performs the technical lab test on a formalin–fixed paraffin–embedded (FFPE) tumor tissue specimen for mRNA gene expression profiling of 31 genes (28 content and 3 housekeeping) and… | 9,380 | $7,050 | $66.1M |
| 81552 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 15 genes and carries out an algorithmic analysis using patient data and the lab–test results to report a risk… | 390 | $7,600 | $3M |
| 0090U | 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 0090U for… | 480 | $1,720 | $822.2K |
| 81418 | Code 81418 describes a test to evaluate a blood or saliva specimen for changes in at least six genes that may impact metabolism of many therapeutic drugs. The test must include CYP2C19 and CYP2D6… | 490 | $920 | $454.5K |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 130 | $1,540 | $204.4K |
| 0411U | 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 0411U only for… | 150 | $900 | $136.6K |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 250 | $440 | $108.7K |
| 81225 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19. | 310 | $290 | $88.4K |
| 81227 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 9, also known as CYP2C9. | 10 | $170 | $2.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81529 | The lab analyst performs the technical lab test on a formalin–fixed paraffin–embedded (FFPE) tumor tissue specimen for mRNA gene expression profiling of 31 genes (28 content and 3 housekeeping) and… | 1,920 | $540 | $1M |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 1,040 | $140 | $140.3K |
| 0411U | 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 0411U only for… | 1,470 | $30 | $42.7K |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 1,080 | $30 | $28.2K |
| 81225 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19. | 1,680 | $20 | $26.8K |
| 0315U | 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 0315U for… | 30 | $290 | $8.5K |
| 0090U | 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 0090U for… | 30 | $260 | $7.4K |
| 888888 | N/A | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 3 | 10 | 1,340 | $200 | $1.2M |
| 81529 | The lab analyst performs the technical lab test on a formalin–fixed paraffin–embedded (FFPE) tumor tissue specimen for mRNA gene expression profiling of 31 genes (28 content and 3 housekeeping) and… | 1 | 10 | 1,920 | $540 | $1M |
| 0411U | 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 0411U only for… | 1 | 10 | 1,470 | $30 | $42.5K |
| 81226 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily D, polypeptide 6, also known as CYP2D6. | 1 | 10 | 1,080 | $30 | $28.7K |
| 81225 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene for cytochrome P450, family 2, subfamily C, polypeptide 19, also known as CYP2C19. | 1 | 10 | 1,680 | $20 | $26.3K |
| 0315U | 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 0315U for… | 1 | 10 | 30 | $290 | $8.5K |
| 0090U | 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 0090U for… | 1 | 10 | 30 | $260 | $7.4K |
| 888888 | N/A | 1 | 10 | 10 | $0 | $0 |
Other providers in the same ZIP code as Castle Biosciences, Inc, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.