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NPI 1770833121 · San Diego, CA · Clinical Medical Laboratory
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Veracyte Labs Sd Corporation is a clinical medical laboratory provider located in San Diego, California. This profile covers 3 Medicare and 2 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 | Veracyte Labs Sd Corporation |
| Address | 6925 Lusk Blvd Ste 200 |
| City | San Diego |
| State | CA |
| ZIP | 92121 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | September 13, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $75M |
| Medicaid | $2.4M |
VERACYTE LABS SD CORPORATION presents as a specialized molecular diagnostics laboratory: the Medicare and Medicaid billing is overwhelmingly driven by 81542, an mRNA gene expression profiling assay for prostate cancer risk, and supported by pathology workup code 88381 (manual microdissection). The presence of high-volume, high-pay codes for algorithmic gene-expression testing and specimen microdissection indicates the operation centers on centralized, high-complexity lab testing rather than routine clinical laboratory panels.
The provider’s Medicare revenue is highly concentrated: precomputed top 3 Medicare codes account for 100.0% of its total Medicare revenue, with 81542 alone representing 95.6% of Medicare revenue. In Medicare detail, 81542 appears as 18.9K claims with $3789 avg paid/claim generating $71.7M of the $75M total Medicare revenue, while 88381 accounts for 18K claims and $3.2M in Medicare revenue.
Medicaid billing mirrors the Medicare concentration: precomputed top 3 Medicaid codes account for 100.0% of total Medicaid revenue, with 81542 comprising 94.5% of Medicaid revenue. On Medicaid, 81542 appears as 3K claims at $756 avg paid/claim producing $2.3M of the $2.4M total Medicaid revenue, and 88381 contributes $133.7K from 3.3K claims.
Payer mix is heavily Medicare-weighted: the provider reports $75M in total Medicare revenue versus $2.4M in total Medicaid revenue, indicating Medicare is the dominant payer by scale and the business is effectively single-payer dominated. Medicaid activity exists but is small relative to Medicare and concentrated in the same molecular/pathology codes.
Competitive standing on Medicare shows a mixed profile: 81542 is listed as ranks #1 of 1 providers nationally (0th percentile; no national peer volume comparison available), indicating either sole or non-comparable national reporting for that code, while 88381 ranks #2 of 224 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), marking the provider as an unusually large reporter of pathology microdissection compared with peers.
In-state competitive posture on Medicaid is similar: 81542 ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), suggesting this lab is the sole or uniquely reported in-state provider for that assay, whereas 88381 ranks #2 of 11 providers in-state (90th percentile; typical, unremarkable volume for this code), indicating routine pathology service volumes relative to state peers.
The provider’s tenure and per-test economics underline a mature specialized lab operation: the NPI was enumerated on 2012-09-13 (~14 years ago), and 81542 carries a high avg paid/claim ($3789 in Medicare, $756 in Medicaid) consistent with complex molecular testing revenue streams. Smaller items such as 0016M (17 claims, $3420 avg paid/claim, $58.1K Medicare revenue) are present but collectively immaterial to overall revenue concentration and also rank #1 of 1 providers nationally (0th percentile; no national peer volume comparison available).
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81542 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 22 genes and carries out an algorithmic analysis using patient data and the lab–test results to report a risk… | 18,930 | $3,790 | $71.7M |
| 88381 | A clinician, typically a pathologist, performs a manual microdissection of a patient’s specimen, such as a biopsy or tissue preserved from a previous case. | 18,030 | $180 | $3.2M |
| 0016M | N/A | 20 | $3,420 | $58.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81542 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 22 genes and carries out an algorithmic analysis using patient data and the lab–test results to report a risk… | 3,020 | $760 | $2.3M |
| 88381 | A clinician, typically a pathologist, performs a manual microdissection of a patient’s specimen, such as a biopsy or tissue preserved from a previous case. | 3,260 | $40 | $133.7K |
How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. California median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81542 | The lab analyst performs the technical lab tests for mRNA gene expression profiling for 22 genes and carries out an algorithmic analysis using patient data and the lab–test results to report a risk… | 1 | 10 | 3,020 | $760 | $2.3M |
| 88381 | A clinician, typically a pathologist, performs a manual microdissection of a patient’s specimen, such as a biopsy or tissue preserved from a previous case. | 2 | 10 | 410 | $80 | $259.5K |
Other providers in the same ZIP code as Veracyte Labs Sd Corporation, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Precision Toxicology, LLC | CA | Clinical Medical Laboratory | $13.8M | $213.8M |
| Sequenom Center For Molecular Medicine LLC | CA | Clinical Medical Laboratory | $0 | $74.1M |
| Biotheranostics, Inc. | CA | Clinical Medical Laboratory | $38.4M | $4M |
| H&m Molecular Diagnostics, LLC | CA | Clinical Medical Laboratory | $13.3M | $11.2M |
| Helix, Inc. | CA | Clinical Medical Laboratory | $169.2K | $22.6M |
| Scripps Health | CA | Clinical Medical Laboratory | $8.9M | $301.7K |
| Biocept, Inc. | CA | Clinical Medical Laboratory | $254.7K | $5.6M |
| Iain Macewan | CA | Radiation Oncology Physician | $2.2M | $0 |
| Prometheus Laboratories Inc. | CA | Clinical Medical Laboratory | $338.8K | $1.6M |
| Neogenomics Laboratories Inc | CA | Clinical Medical Laboratory | $1.8M | $0 |
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