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NPI 1851059588 · Irving, TX · Clinical Medical Laboratory
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Texas Molecular Diagnostics Laboratory is a clinical medical laboratory provider located in Irving, Texas. This profile covers 52 Medicare and 37 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 | Texas Molecular Diagnostics Laboratory |
| Address | 4324 N Belt Line Rd Ste C105 |
| City | Irving |
| State | TX |
| ZIP | 75038 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | November 30, 2021 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $43M |
| Medicaid | $11.6K |
Business/service-line focus: The provider’s Medicare code mix is heavily weighted to high-complexity molecular and gene-sequencing tests rather than routine anatomic pathology or simple infectious panels. Top Medicare codes include a high volume amplified-probe infectious code (87798: 125.8K claims, $4.3M revenue) alongside multiple full-gene sequencing codes such as 81185 and 81249 (each generating multi‑million dollars), indicating an operational focus on large-scale molecular diagnostics and specialty genetic testing.
Revenue concentration in Medicare: Revenue is meaningfully concentrated in a small set of tests — the precomputed top-3 Medicare codes account for 28.4% of this provider’s total Medicare revenue. Those top-three contributors include 87798 ($4.3M, 11.4% of Medicare revenue), 81185 ($3.2M, 8.6%), and 81249 ($3.2M, 8.4%), showing that a handful of high-volume and/or high-unit‑price codes drive a disproportionate share of earnings.
Medicaid revenue is de minimis and highly concentrated: This provider reports $11.6K in lifetime Medicaid revenue, with the precomputed top-3 Medicaid codes accounting for 97.2% of that amount. The dominant Medicaid codes are 87635 ($5.2K, 45.7%), U0003 ($4.4K, 39.0%), and U0005 ($1.4K, 12.5%), reflecting that Medicaid activity is essentially limited to SARS‑CoV‑2 testing lines and represents a negligible share of overall payer dollars.
Payer mix and scale: The practice is effectively Medicare-dominant in scale — lifetime Medicare revenue is $43M versus only $11.6K from Medicaid — indicating the business operates at a scale driven almost entirely by Medicare volume and payments. From a contracting and network strategy perspective, the provider’s commercial and Medicare-facing operations will be far more material to revenue than any Medicaid arrangements.
Competitive standing and statistical outlier signals (Medicare): For many specialized sequencing codes this lab ranks at the very top nationally (numerous codes listed as rank #1 and 100th percentile) and is described as an "extreme outlier" for multiple high-revenue codes (for example, 81185 and 81249 rank #1 nationally and are extreme outliers). Even the high-volume infectious code 87798 ranks #8 of 1319 providers and is labeled an "extreme outlier," which collectively signals a dominant national presence for several specific molecular tests rather than a modest local lab footprint.
Operational implications from claim volumes and unit pricing: Several Medicare codes combine large claim counts with high average paid per claim (for example, 87798 has 125.8K claims at $34 avg paid/claim generating $4.3M, while 81185 shows 4K claims at $812 avg paid/claim generating $3.2M). This pattern suggests the lab runs both high-throughput infectious testing and higher‑margin, lower-frequency full-gene sequencing services — a mixed throughput model that requires substantial lab infrastructure and reimbursement management.
Medicaid payment patterns and billing detail: Many Medicaid-listed codes show claims but report $0 avg paid/claim and $0 revenue for numerous test lines, indicating either non‑paying claim submissions, denied/zero‑paid line items, or state payment policy effects for certain specimen or collection codes. Analysts should treat Medicaid figures as unreliable for estimating operational scale beyond the specific SARS‑CoV‑2 codes (87635, U0003, U0005) that account for virtually all Medicaid dollars here.
Tenure and recent activity window: The provider’s NPI was enumerated on 2021-11-30 (~5 years ago), indicating a relatively recent market entry that has nonetheless achieved rapid scaling in select molecular and genetic test lines. Given the combination of recent enumeration and outsized national ranks on specialized codes, this suggests deliberate, fast growth focused on specific high‑value diagnostics rather than a long-established, broad-spectrum clinical lab footprint.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
52 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… | 125,800 | $30 | $4.3M |
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 3,990 | $810 | $3.2M |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 5,370 | $590 | $3.2M |
| 81307 | The lab analyst performs the technical lab test on a specimen such as blood, to analyze the entire gene sequence for the partner and localizer of BRCA2 (PALB2) gene. | 4,300 | $660 | $2.9M |
| 81317 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the postmeiotic segregation increased 2 [S. cerevisiae], or PMS2 gene. | 4,270 | $660 | $2.8M |
| 81298 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the mutS homolog 6 [E. coli], or MSH6 gene. | 4,280 | $630 | $2.7M |
| 81238 | The lab analyst performs the technical lab test to analyze the full gene sequence of the coagulation factor IX (F9) gene. | 4,300 | $580 | $2.5M |
| 81325 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the peripheral myelin protein 22, or PMP22, gene. | 2,870 | $750 | $2.2M |
| 81302 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the methyl CpG binding protein 2, or MECP2 gene. | 3,990 | $520 | $2.1M |
| 81223 | The lab analyst performs the technical lab test to analyze the entire gene sequence for cystic fibrosis transmembrane conductance regulator gene, also known as CFTR. | 4,310 | $410 | $1.8M |
Showing 1–10 of 52
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
52 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81185 | 1 | 10 | 110 | $820 | $906.1K |
| 81325 | 1 | 10 | 90 | $750 | $582.2K |
| 81302 | 1 | 10 | 90 | $520 | $479.9K |
| 81317 | 1 | 20 | 220 | $660 | $382.7K |
| 81298 | 1 | 20 | 220 | $630 | $362.7K |
| 81307 | 1 | 20 | 150 | $660 | $361.4K |
| 81249 | 1 | 20 | 80 | $590 | $319.2K |
| 81238 | 1 | 20 | 110 | $590 | $281.7K |
| 81309 | 1 | 10 | 110 | $270 | $278.9K |
| 81189 | 1 | 10 | 110 | $270 | $278.2K |
Showing 1–10 of 52
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 210 | $30 | $5.2K |
| 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… | 180 | $30 | $4.4K |
| 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,… | 180 | $10 | $1.4K |
| 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… | 160 | $1 | $310 |
| 81185 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the calcium voltage–gated channel subunit alpha1 A gene, also called CACNA1A. | 30 | $0 | $0 |
| 81189 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the cystatin B gene (CSTB). | 30 | $0 | $0 |
| 81249 | The lab analyst performs the technical lab test to analyze known the full gene sequence of the glucose–6–phosphate dehydrogenase (G6PD) gene. | 30 | $0 | $0 |
| 81256 | The lab analyst performs the technical lab test to detect the presence of common changes in the hemochromatosis gene, also known as HFE. | 30 | $0 | $0 |
| 81275 | The lab analyst performs the technical lab test to detect the presence of common changes in the gene Kirsten rat sarcoma viral oncogene homolog, also known as KRAS, which occur in exon 2. | 20 | $0 | $0 |
| 81302 | The lab analyst performs the technical lab test to analyze the entire gene sequence for the methyl CpG binding protein 2, or MECP2 gene. | 30 | $0 | $0 |
Showing 1–10 of 37
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas median
37 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 208 | 340 | 400 | $50 | $553.5K |
| 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… | 164 | 240 | 420 | $30 | $296.8K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 211 | 290 | 410 | $20 | $225K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 217 | 300 | 410 | $20 | $223.4K |
| 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,… | 96 | 140 | 180 | $60 | $215.9K |
| 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,… | 178 | 260 | 640 | $20 | $137.2K |
| 87502 | The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly… | 239 | 350 | 230 | $70 | $120.3K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 111 | 170 | 440 | $20 | $93.6K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 454 | 850 | 260 | $40 | $77.5K |
| 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. | 274 | 420 | 340 | $20 | $73.4K |
Showing 1–10 of 37
Other providers in the same ZIP code as Texas Molecular Diagnostics Laboratory, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Green Apple LLC | TX | Home Health Agency | $0 | $59.8M |
| Therapy 2000 Inc | TX | Home Health Agency | $0 | $47.8M |
| Careflite | TX | Ambulance | $11M | $14.4M |
| Northstar Anesthesia Of Michigan Iii PLLC | TX | Pain Medicine (Anesthesiology) Physician | $0 | $12.7M |
| Northstar Anesthesia Of Michigan PLLC | TX | Anesthesiology Physician | $0 | $12M |
| Houston Neurodiagnostics, LLC | TX | Physiological Laboratory | $1.7M | $8.5M |
| V-labs America Inc | TX | Clinical Medical Laboratory | $2.4M | $1K |
| Charles Powell | TX | Family Medicine Physician | $1.1M | $0 |
| Sumana Ketha | TX | Internal Medicine Physician | $605.1K | $500 |
| Padmavathy Uppalapati | TX | Cardiovascular Disease Physician | $283.4K | $0 |
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