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NPI 1871615708 · Brentwood, TN · Clinical Medical Laboratory
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Accupath Diagnostic Laboratories Inc is a clinical medical laboratory provider located in Brentwood, Tennessee. This profile covers 40 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 | Accupath Diagnostic Laboratories Inc |
| Address | 201 Summit View Dr |
| City | Brentwood |
| State | TN |
| ZIP | 37027 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | April 4, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $5.4M |
| Medicare | $4.4M |
This provider bills both Medicare and Medicaid at meaningful scale: Total Medicare revenue is $4.4M while total Medicaid revenue is $5.4M, so Medicaid is the slightly larger payer but the practice is not single‑payer. The presence of substantial revenue on both programs indicates it operates across public payers rather than being concentrated on one only.
Revenue concentration on Medicare is high and driven by a small set of specialized codes: the precomputed top 3 Medicare codes account for 49.7% of Medicare revenue, led by 81479 ($1.1M revenue, 25.9%), followed by 88185 ($718.2K, 16.6%) and 88237 ($314.4K, 7.3%). This concentration shows a reliance on molecular pathology, flow cytometry add‑on testing, and neoplastic cell culture procedures for a large share of Medicare receipts.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes account for 65.7% of Medicaid revenue, dominated by 88185 ($2.9M revenue, 53.9%) with 88189 ($344.3K, 6.5%) and 88341 ($283.9K, 5.3%) rounding out the top three. That pattern indicates Medicaid billing is heavily weighted toward high‑volume flow cytometry technical work plus interpretive and additional IHC staining services.
The mix of high‑revenue codes indicates a specialty laboratory profile focused on hematopathology/oncology and complex diagnostic testing: repeated prominence of flow cytometry codes (88185, 88184, 88189), cytogenetics/FISH and karyotype codes (88264, 88271, 88275, 88237), and molecular panels (81479, 81450) points to an operation that performs high‑volume marker panels, cytogenetic analysis, and molecular sequencing. This code mix is consistent with a lab that supports cancer and blood‑disorder diagnostics rather than primarily routine chemistry or anatomic pathology alone.
On national Medicare benchmarks the provider is a clear high‑volume outlier for several specialized services: 88185 ranks #7 of 618 (99th percentile; extreme outlier) and 88264 ranks #1 of 76 (100th percentile; extreme outlier), while other codes such as 88189 and 88341 also sit at very high percentiles. Those rankings indicate the lab is operating at volumes far above typical national peers for multiple complex hematopathology and cytogenetics procedures.
In‑state (Tennessee) Medicaid comparisons show dominance for many codes: 88185, 88189, 88341, 88237, 88184 and several others all rank #1 in‑state (100th percentile or labeled as notably above typical state volume). This pattern portrays the provider as the leading regional source for flow cytometry, IHC and cytogenetics testing, and suggests strong referral relationships or contracting within the state.
The combination of extreme/high percentiles across both payers and the heavy revenue concentration (Medicare top 3 = 49.7%; Medicaid top 3 = 65.7%) creates operational sensitivity: changes in reimbursement, prior authorization, or utilization management focused on core codes like 88185, 81479, or key cytogenetics codes could materially affect revenue. The firm’s dependence on a small set of specialized services also implies any payer policy shifts targeting these modalities would have outsized impact.
ACCUPATH DIAGNOSTIC LABORATORIES INC is a long‑tenured laboratory, with NPI enumerated 2007-04-04 (~19 years ago), which supports the interpretation that its high volumes and state presence are established rather than new. That tenure, combined with specialized code dominance, suggests established clinical relationships and operational capacity to deliver complex hematopathology and molecular diagnostics at scale.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
40 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 2,500 | $450 | $1.1M |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 47,880 | $20 | $718.2K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 2,230 | $140 | $314.4K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 5,340 | $50 | $267.1K |
| 81450 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes known to impact… | 360 | $740 | $263.4K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 4,040 | $60 | $250.4K |
| 88264 | The analyst performs a chromosome analysis and analyzes 20 to 25 cells. The analysis includes counting the number of chromosomes in each cell and preparing a karyotype for each cell examined. | 1,660 | $140 | $235.9K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 7,330 | $30 | $227.1K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 8,310 | $20 | $174.5K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 1,990 | $50 | $103.6K |
Showing 1–10 of 40
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 40 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
40 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 81479 | 1 | 10 | 180 | $930 | $692.4K |
| 81450 | 2 | 10 | 320 | $740 | $219.7K |
| 88275 | 1 | 10 | 2,720 | $50 | $136.4K |
| 88271 | 1 | 10 | 4,240 | $20 | $89K |
| 88305 | 49 | 420 | 500 | $30 | $55.1K |
| 88185 | 1 | 30 | 690 | $20 | $51.2K |
| 88237 | 1 | 10 | 110 | $140 | $50K |
| 81263 | 1 | 10 | 80 | $290 | $42.5K |
| 81235 | 1 | 10 | 120 | $320 | $37.2K |
| 88264 | 1 | 10 | 60 | $140 | $36.1K |
Showing 1–10 of 40
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.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 15,030 | $190 | $2.9M |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 12,750 | $30 | $344.3K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 5,460 | $50 | $283.9K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 6,540 | $40 | $281.3K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 14,100 | $20 | $267.9K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 4,190 | $40 | $163.5K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 6,780 | $20 | $122K |
| 88264 | The analyst performs a chromosome analysis and analyzes 20 to 25 cells. The analysis includes counting the number of chromosomes in each cell and preparing a karyotype for each cell examined. | 3,700 | $30 | $118.3K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 4,330 | $30 | $116.8K |
| 81450 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes known to impact… | 610 | $190 | $115.1K |
Showing 1–10 of 37
How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Tennessee median
37 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 1 | 10 | 770 | $140 | $500.5K |
| 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… | 61 | 200 | 600 | $30 | $168.3K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 1 | 10 | 20 | $40 | $95K |
| 88361 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. The lab analyst processes the slides using computer assisted… | 1 | 10 | 840 | $110 | $92.9K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 1 | 10 | 2,140 | $40 | $84.8K |
| 81207 | The lab analyst performs the technical lab test to evaluate the minor breakpoint gene sequence BCR/ALB1 that occurs on chromosome 22 due to translocation, which involves breakage and reforming of an… | 1 | 10 | 2,520 | $30 | $83K |
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 3 | 10 | 60 | $60 | $67.6K |
| 81206 | The lab analyst performs the technical lab test to evaluate the major breakpoint gene sequence BCR/ALB1 that occurs on chromosome 22 due to translocation, which involves breakage and reforming of an… | 1 | 10 | 1,530 | $40 | $63K |
| 81450 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes known to impact… | 1 | 10 | 380 | $160 | $58.7K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 1 | 10 | 700 | $20 | $53.1K |
Showing 1–10 of 37
Other providers in the same ZIP code as Accupath Diagnostic Laboratories Inc, ranked by combined Medicare and Medicaid revenue.
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