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NPI 1881679751 · Houston, TX · Clinical Medical Laboratory
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Laboratory Corporation Of America is a clinical medical laboratory provider located in Houston, Texas. This profile covers 478 Medicare and 423 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 | Laboratory Corporation Of America |
| Address | 7207 Gessner Dr |
| City | Houston |
| State | TX |
| ZIP | 77040 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | December 13, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $103.8M |
| Medicare | $27.2M |
This entity is effectively a Medicaid-dominant laboratory: lifetime Medicaid revenue is $103.8M versus Medicare revenue of $27.2M, indicating most billed dollars come from Medicaid rather than Medicare. The provider’s NPI was enumerated 2005-12-13 (~21 years ago), reflecting a long-established presence in the market and capacity to service large payer volumes.
The code mix and taxonomy (Clinical Medical Laboratory) show a high-volume reference laboratory model focused on routine outpatient diagnostics and large-scale specimen processing; Medicare top codes include 80053 ($2.5M, 249.2K claims), 36415 ($2.2M, 275.3K claims), and 80061 ($2.1M, 164.1K claims), consistent with high-throughput chemistry, phlebotomy and lipid/A1C/CMP workflows. These routine panels and venipuncture codes dominate Medicare activity and suggest centralized processing of ambulatory specimens rather than a small on-site lab operation.
Medicaid billing emphasizes molecular, infectious disease and population-screening work: high Medicaid revenues appear for 81420 ($7.5M, 24.1K claims), U0003 ($7M, 97.4K claims), and 80050 ($6.9M, 265.9K claims), plus large volumes of STD NAATs (87491 and 87591, each ~$6.4M with ~304K claims). This mix indicates substantial investment in high-complexity genomic and nucleic-acid testing and broad public-health related screening services that drive Medicaid revenue.
Revenue concentration differs by payer: the top 3 Medicare codes account for 35.2% of this provider’s Medicare revenue, with the single Medicare leaders 80053 ($2.5M, 12.8%), 36415 ($2.2M, 11.3%), and 80061 ($2.1M, 11.0%). On Medicaid, the top 3 codes account for 27.1% of Medicaid revenue, led by 81420 ($7.5M, 9.5%), U0003 ($7M, 8.9%), and 80050 ($6.9M, 8.7%), showing meaningful but somewhat lower concentration across a broader set of tests.
Nationally on Medicare this provider is a dominant volume outlier for many routine assays: multiple Medicare codes (for example 80053 ranks #23 of 26416, 36415 ranks #24 of 86467, 80061 ranks #25 of 21671) are marked as 100th percentile or "extreme outlier," indicating volumes far above typical national peers and a reference-lab scale of operations. Those extreme-percentile rankings for core chemistry and hematology codes imply the provider is a major national processor for standard Medicare lab work.
State-level competitive standing in Texas for Medicaid is also strong but more mixed by test type: several Medicaid codes are ranked among the top in-state (81420 #2 of 17, 80050 #4 of 148, 87491 #4 of 301), with many codes described as "extreme outlier" or in the 97th–99th percentiles statewide. This positioning indicates the provider is a leading in-state laboratory for genomic prenatal screening, high-volume panels, and STD/infectious disease testing.
The provider’s service footprint includes specialty testing and women’s health/genetics: significant Medicaid revenues appear for prenatal and genetic tests such as 81420 ($7.5M) and 81220 ($3.2M), as well as obstetric panel 80081 ($3.6M) and cytology 88175 ($2.2M). These lines, together with very large claim counts for screening and infectious disease tests, suggest a substantial business focus on prenatal, reproductive health, and population screening services.
Toxicology and definitive drug testing are material revenue drivers across payers: Medicare shows 80307 ($250.6K, ranks #50 of 4760, 99th percentile) and G0480 ($198.8K), while Medicaid lists 80307 at $5.1M (3rd in-state, 99th percentile) and G0480 at $1.2M (5th in-state). The prominence of both presumptive and definitive drug-testing codes, especially in Medicaid, signals a notable revenue stream from toxicology and workforce/clinical-drug monitoring services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
478 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 249,180 | $10 | $2.5M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 275,280 | $10 | $2.2M |
| 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. | 164,140 | $10 | $2.1M |
| 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… | 128,880 | $20 | $2.1M |
| 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… | 59,500 | $30 | $1.7M |
| 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… | 213,960 | $10 | $1.7M |
| 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).… | 124,270 | $10 | $1.2M |
| 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. | 22,690 | $40 | $907.6K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 46,540 | $10 | $418.8K |
| 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… | 22,530 | $20 | $405.5K |
Showing 1–10 of 478
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 478 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
478 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 87798 | 269 | 300 | 790 | $30 | $265.1K |
| 81490 | 2 | 10 | 170 | $830 | $150.2K |
| 87900 | 4 | 10 | 50 | $130 | $111.5K |
| 81279 | 16 | 20 | 270 | $180 | $86.8K |
| 87801 | 116 | 120 | 170 | $70 | $86.5K |
| G0483 | 41 | 170 | 150 | $240 | $84.9K |
| 86003 | 7 | 10 | 8,740 | $10 | $78.5K |
| 87536 | 3 | 10 | 560 | $80 | $75.8K |
| U0003 | 12 | 60 | 100 | $70 | $64.7K |
| 86480 | 5 | 30 | 60 | $60 | $61.4K |
Showing 1–10 of 478
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.
423 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 24,080 | $310 | $7.5M |
| 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… | 97,400 | $70 | $7M |
| 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… | 265,910 | $30 | $6.9M |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 304,910 | $20 | $6.4M |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 304,270 | $20 | $6.4M |
| 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. | 155,250 | $30 | $5.1M |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 274,470 | $10 | $3.8M |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 84,070 | $40 | $3.6M |
| 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… | 304,580 | $10 | $3.4M |
| 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. | 651,470 | $10 | $3.3M |
Showing 1–10 of 423
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
423 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81420 | The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,… | 2 | 20 | 950 | $300 | $3.2M |
| 81220 | The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR… | 3 | 20 | 180 | $200 | $923K |
| 80081 | The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen test, a single–result test for HIV–1 antigens… | 3 | 20 | 250 | $40 | $821.3K |
| 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 | 340 | 400 | $50 | $553.5K |
| 87636 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic… | 34 | 160 | 200 | $110 | $323.8K |
| 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… | 4 | 150 | 170 | $30 | $302.9K |
| 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… | 17 | 240 | 420 | $30 | $296.8K |
| 88175 | 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… | 3 | 70 | 800 | $20 | $268.3K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 2 | 20 | 1,370 | $40 | $268.3K |
| 86003 | The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or… | 3 | 30 | 200 | $20 | $262.8K |
Showing 1–10 of 423
Other providers in the same ZIP code as Laboratory Corporation Of America, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Genview Diagnosis Inc | TX | Clinical Medical Laboratory | $1.1M | $8.9M |
| Rapid Dx Laboratory LLC | TX | Clinical Medical Laboratory | $4.8M | $927.8K |
| Jason Baron | TX | Psychiatry Physician | $127.6K | $0 |
| Mirlene Appolon | TX | Family Nurse Practitioner | $117.2K | $6.4K |
| Babatunde Otinwa | TX | Emergency Medicine Physician | $116.3K | $0 |
| Nowice Trexler | TX | Diagnostic Radiology Physician | $83.8K | $0 |
| Adam Alli | TX | Vascular & Interventional Radiology Physician | $81.2K | $0 |
| Jaideep Barge | TX | Diagnostic Radiology Physician | $40.5K | $0 |
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