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NPI 1811982549 · North Platte, NE · Clinical Pathology/Laboratory Medicine Physician
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Pathology Services, P.C. is a clinical pathology/laboratory medicine physician provider located in North Platte, Nebraska. This profile covers 80 Medicare and 47 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 | Pathology Services, P.C. |
| Address | 1931 W A St |
| City | North Platte |
| State | NE |
| ZIP | 69101 |
| Taxonomy | Clinical Pathology/Laboratory Medicine Physician |
| NPI Enumerated | September 19, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $621.3K |
| Medicaid | $424.3K |
PATHOLOGY SERVICES, P.C. operates as a high-volume clinical pathology / laboratory medicine practice: its top Medicare revenue drivers are diagnostic lab panels and analytes such as 84443 (TSH), 80053 (CMP), and 80061 (lipid panel), and its Medicare billing profile is dominated by routine chemistry, hematology and endocrinology testing rather than surgical pathology or complex procedures. The Medicare portfolio includes high claim counts (e.g., 80053: 8.1K claims; 84443: 5.3K claims; 80061: 4.5K claims), consistent with an outpatient clinical laboratory processing steady specimen volumes.
Medicare revenue is concentrated: the practice reported total Medicare revenue of $621.3K and the precomputed top-3 Medicare codes account for 39.4% of that total. Those top-three contributors break down at the code level (84443 at 15.0%, 80053 at 14.2%, 80061 at 10.2%), indicating meaningful dependence on a small set of routine lab tests for a large share of Medicare receipts.
Medicaid billing is also concentrated but weighted differently: total Medicaid revenue is $424.3K and the top-3 Medicaid codes account for 37.9% of Medicaid revenue. The leading Medicaid drivers include 80050 (21.1%), 88142 (9.4%), and 80053 (7.3%), showing a material role for bundled general health panels and cytology/STD-related services in the state payer mix.
Payer mix is mixed but leans Medicare: Medicare revenue ($621.3K) exceeds Medicaid revenue ($424.3K), so the practice is not single-payer and must manage contracts and operations across both programs. Both payers contribute meaningfully to the business, meaning changes in reimbursement or referral patterns from either channel could materially affect total revenue.
National competitive standing on Medicare tests is pronounced for routine analytes: multiple high-revenue Medicare codes place the provider in top national percentiles (for example, 84443 ranks #220 of 19722 providers nationally at the 99th percentile, 80053 ranks #247 of 26416 at the 99th percentile, and 80061 ranks #254 of 21671 at the 99th percentile). The dataset labels these code volumes as 'typical, unremarkable volume for this code', which suggests that while the provider’s absolute ranks are high, the pattern aligns with expected high-throughput laboratory activity rather than an anomalous billing profile.
State-level competitive positioning on Medicaid is mixed: the highest Medicaid revenue code 80050 ranks #13 of 43 in-state (71th percentile) suggesting a solid but not dominant statewide position for general health panels, while 80053 ranks #20 of 133 (86th percentile) and 83036 ranks #13 of 111 (89th percentile), indicating stronger in-state presence for CMPs and A1C testing. Conversely, some service lines tied to surgical pathology (for example, 88305) are lower-ranked in-state (88305 is #37 of 46, 20th percentile) and represent a relatively small Medicaid revenue contribution.
Operational footprint is consistent with a high-throughput outpatient lab: frequent specimen collection and basic testing codes appear among top Medicare and Medicaid items (e.g., 36415 with 5.7K Medicare claims and 7.6K Medicaid claims; 85025 with 4.9K Medicare claims and 5.2K Medicaid claims). These volumes, together with material payments for panels and analytes (examples: Medicare revenues of $85.5K for 84443 and $81.2K for 80053; Medicaid revenue of $85.6K for 80050), point to an operational model built around routine diagnostic testing and specimen processing rather than low-volume subspecialty pathology.
The provider has an established tenure in the market, with NPI enumeration on 2005-09-19 (~21 years ago), supporting the inference of a stable local operation and long-standing relationships with clinicians and payers. That longevity combined with the concentrated test mix suggests operational continuity where incremental changes in referral patterns or payer reimbursement for a few high-impact codes could disproportionately affect overall revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
80 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 5,340 | $20 | $85.5K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 8,120 | $10 | $81.2K |
| 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. | 4,470 | $10 | $58.1K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 5,740 | $10 | $45.9K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 4,860 | $10 | $38.9K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 3,460 | $10 | $34.6K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 990 | $30 | $28.8K |
| 83970 | Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function. | 580 | $40 | $23.2K |
| 83880 | The lab analyst measures the amount of natriuretic peptide, a hormone made by heart muscle cells, in the patient specimen. Blood levels of the hormone increase in patients with congestive heart… | 540 | $40 | $20.3K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 990 | $20 | $17.9K |
Showing 1–10 of 80
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 80 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.
47 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 2,520 | $30 | $85.6K |
| 88142 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 2,130 | $20 | $38.3K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 7,450 | $1 | $29.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 970 | $30 | $28.2K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 960 | $30 | $27.8K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 4,210 | $10 | $25.3K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 5,210 | $1 | $20.9K |
| 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. | 3,600 | $10 | $18K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 7,590 | $1 | $15.2K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 510 | $30 | $14.8K |
Showing 1–10 of 47
How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nebraska median
47 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 37 | 50 | 1,140 | $60 | $200K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 10 | 30 | 730 | $30 | $89.8K |
| 87624 | The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result. | 8 | 10 | 1,240 | $30 | $78.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 10 | 30 | 720 | $20 | $73.6K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 20 | 130 | 1,410 | $10 | $69.2K |
| 88307 | The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 15 | 20 | 190 | $70 | $59.3K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 13 | 40 | 530 | $20 | $53.8K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 30 | 150 | 1,610 | $10 | $47K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 14 | 40 | 310 | $30 | $42.2K |
| 88142 | The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer… | 4 | 10 | 950 | $20 | $39.8K |
Showing 1–10 of 47
Other providers in the same ZIP code as Pathology Services, P.C., ranked by combined Medicare and Medicaid revenue.
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