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NPI 1790274678 · Bingham Farms, MI · Clinical Medical Laboratory
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Heritage Labs, Inc. is a clinical medical laboratory provider located in Bingham Farms, Michigan. This profile covers 74 Medicare and 69 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 | Heritage Labs, Inc. |
| Address | 30600 Telegraph Rd Ste 1375 |
| City | Bingham Farms |
| State | MI |
| ZIP | 48025 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | May 6, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $12M |
| Medicaid | $2.3M |
HERITAGE LABS, INC. appears to operate as a high-volume COVID test distributor/processor and a clinical toxicology lab: Medicare billing is dominated by K1034 (Provision of covid-19 test, nonprescription self-administered and self-collected use) which accounts for $11.4M and 93.6% of the provider’s Medicare revenue, while additional Medicare lines include definitive drug testing codes such as G0483 and G0480. This code mix indicates a combination of mass distribution/fulfillment for nonprescription COVID self-tests together with laboratory-based drug-testing services rather than a narrow anatomic pathology or routine clinical-testing footprint.
Medicare revenue is extremely concentrated: the precomputed top 3 Medicare codes account for 96.2% of the provider’s total Medicare revenue. That concentration — driven overwhelmingly by a single code (K1034) — means the provider’s Medicare financial profile is highly sensitive to reimbursement policy or coding guidance changes affecting those few codes.
K1034 is an outlier at the national level: HERITAGE LABS ranks #47 of 30143 providers nationally for K1034 and is explicitly labeled an "extreme outlier, far above typical national volume for this code." In contrast, its other Medicare test codes (e.g., G0483, G0480, 80307) show elevated but more typical volumes (many in the upper percentiles), suggesting national dominance specifically for the COVID self-test provision line but only a strong yet not singular competitive position in toxicology testing.
On the Medicaid side the revenue mix shifts toward drug-testing and high-throughput COVID testing: G0480 ($732.3K, 32.2%), U0003 ($479.4K, 21.1%), and 80307 ($407.6K, 17.9%) together are the leading Medicaid earners and—per the precomputed metric—HERITAGE’s top 3 Medicaid codes account for 71.1% of its Medicaid revenue. Those Medicaid top codes indicate the lab provides both definitive drug testing services and high-throughput SARS-CoV-2 nucleic acid testing for in-state Medicaid populations.
HERITAGE shows a payer mix heavily weighted to Medicare in scale: total Medicare revenue is $12M versus total Medicaid revenue of $2.3M. This provider is therefore effectively Medicare-first by dollars, with Medicaid representing a substantially smaller portion of lifetime revenue while still supporting material volumes of drug- and COVID-related testing.
Competitive standing differs by payer and code: nationally the provider is a clear outlier on K1034 (#47 of 30143), while its Medicare drug-testing codes sit at high but not extreme percentiles (examples include G0483 at the 89th percentile and G0480 at the 95th percentile). In-state Medicaid rankings for the largest Medicaid codes show a solid regional presence (for example G0480 ranks #19 of 151 providers in-state at the 88th percentile and 80307 ranks #40 of 235 at the 83rd percentile), indicating the lab is an established regional competitor for drug- and COVID-testing but not necessarily the top single statewide provider across those services.
The provider’s enrollment tenure is relatively recent: NPI was enumerated 2018-05-06 (~8 years ago). Achieving very high national volume for K1034 within that timeframe suggests rapid operational scale-up in at least the COVID self-test distribution channel since enumeration.
Operational and reimbursement exposure is concentrated: because the top 3 Medicare codes drive 96.2% of Medicare revenue and the top 3 Medicaid codes drive 71.1% of Medicaid revenue, changes in coverage, reimbursement rates, or billing policy for COVID-related codes (e.g., K1034, U0003) or drug-testing codes (e.g., G0480, G0483) could materially affect revenue. Analysts should monitor policy updates and payer audits focused on those high-share codes given the asymmetric reliance on a small handful of services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
74 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 951,030 | $10 | $11.4M |
| 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… | 830 | $240 | $200.3K |
| G0480 | 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… | 1,110 | $110 | $123.9K |
| 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… | 540 | $190 | $104.4K |
| 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… | 2,920 | $30 | $99.3K |
| 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. | 1,370 | $60 | $83.4K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 1,040 | $30 | $35.4K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 300 | $70 | $20.4K |
| 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… | 230 | $70 | $17.1K |
| 88344 | The lab analyst applies a single multiplex antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 80 | $130 | $11.2K |
Showing 1–10 of 74
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 74 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
74 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G0483 | 2 | 20 | 140 | $240 | $206.2K |
| G0482 | 3 | 50 | 140 | $190 | $109.1K |
| 87798 | 21 | 20 | 380 | $30 | $107.7K |
| K1034 | 18 | 1,090 | 560 | $10 | $64.6K |
| G0480 | 2 | 30 | 270 | $110 | $63.5K |
| G0481 | 17 | 40 | 120 | $150 | $62.1K |
| 87481 | 17 | 10 | 130 | $30 | $27.2K |
| 80307 | 2 | 120 | 130 | $60 | $21.3K |
| 83718 | 4 | 10 | 30 | $10 | $19.7K |
| 87563 | 13 | 10 | 130 | $30 | $17.7K |
Showing 1–10 of 74
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.
69 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0480 | 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… | 11,810 | $60 | $732.3K |
| 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… | 7,990 | $60 | $479.4K |
| 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. | 12,350 | $30 | $407.6K |
| 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,… | 6,750 | $20 | $135K |
| 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… | 940 | $120 | $115.7K |
| 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… | 1,570 | $50 | $70.7K |
| 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… | 1,260 | $50 | $56.8K |
| 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,… | 390 | $90 | $36.7K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 380 | $90 | $34K |
| 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… | 650 | $50 | $31.1K |
Showing 1–10 of 69
How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Michigan median
69 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 32 | 60 | 1,310 | $130 | $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… | 23 | 70 | 680 | $100 | $604K |
| 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… | 43 | 160 | 2,720 | $60 | $546.6K |
| 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… | 24 | 50 | 650 | $80 | $298.5K |
| G0480 | 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… | 19 | 150 | 2,250 | $30 | $202.4K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 132 | 180 | 2,600 | $20 | $162K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 136 | 190 | 2,610 | $20 | $160.2K |
| 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. | 40 | 240 | 2,430 | $20 | $152.2K |
| 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,… | 38 | 130 | 2,270 | $20 | $140.4K |
| 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. | 159 | 270 | 1,950 | $10 | $131.1K |
Showing 1–10 of 69
Other providers in the same ZIP code as Heritage Labs, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gateway Pediatric Therapy LLC | MI | Behavior Analyst | $0 | $125M |
| Byram Healthcare Centers, Inc. | MI | Durable Medical Equipment & Medical Supplies | $0 | $5.3M |
| Catalyst Diagnostic LLC | MI | Clinical Medical Laboratory | $400.9K | $1.7M |
| Anu Patel | MI | Ophthalmology Physician | $1M | $0 |
| Michigan Community Wellness Vna, LLC | MI | Nursing Care Agency | $161.6K | $582.7K |
| Direct Path Services, P.C. | MI | Clinical Medical Laboratory | $444.8K | $122.4K |
| Justin Trivax | MI | Cardiovascular Disease Physician | $534.2K | $0 |
| Mark Karadsheh | MI | Orthopaedic Surgery Physician | $383.3K | $0 |
| Steven Korotkin | MI | Cardiovascular Disease Physician | $375.4K | $0 |
| Karl Kado | MI | Diagnostic Radiology Physician | $356.4K | $0 |
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