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NPI 1922042258 · New Haven, CT · Clinical Medical Laboratory
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Yale University is a clinical medical laboratory provider located in New Haven, Connecticut. This profile covers 11 Medicare and 2 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 | Yale University |
| Address | 15 York St |
| City | New Haven |
| State | CT |
| ZIP | 06510 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | June 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $946.4K |
| Medicaid | $390 |
YALE UNIVERSITY operates as a pathology/clinical laboratory specialty focused on surgical pathology and ancillary immunostains: the Medicare code mix is dominated by surgical pathology and immunohistochemistry charges (notably 88305, 88342, 88312 and related immunostain codes such as 88350, 88341, 88344), reflecting an operation that processes and interprets tissue specimens and performs advanced antibody-based testing. The largest single Medicare line, 88305, alone generated $696.2K in revenue and accounted for 73.8% of the provider's Medicare revenue, indicating the lab’s core service is level IV surgical pathology interpretation.
Medicare revenue is concentrated in a very small number of services: the top 3 Medicare codes account for 84.6% of total Medicare revenue, signaling heavy dependence on a few high-volume pathology services for the provider’s $946.4K lifetime Medicare receipts. This concentration suggests that changes in utilization, reimbursement, or referral patterns for those specific codes would materially affect the provider’s Medicare revenue profile.
On competitive standing, YALE UNIVERSITY is a major national player for its top surgical pathology code 88305 — 88305 produced $696.2K and ranks #203 of 14580 providers nationally (99th percentile) and is described as notably above typical national volume, which indicates a nationally significant volume of complex surgical pathology work. Other Medicare codes such as 88342 ($51.2K, rank #489 of 11370, 96th percentile) and 88312 ($50.3K, rank #327 of 6966, 95th percentile) show strong but more typical volumes relative to national peers.
Several other diagnostic and immunofluorescence codes reflect added-service capability rather than primary revenue drivers: codes like 88350 ($39.2K), 88341 ($38.6K), 88346 ($13.7K) and 88344 ($13.3K) each contribute modest Medicare revenue and are described as typical, unremarkable volumes for those code sets, implying the lab offers ancillary testing at modest scale alongside its dominant surgical pathology services. This mix is consistent with a pathology lab that performs both routine surgical pathology and targeted ancillary immunostaining.
In contrast to Medicare, Medicaid billing is effectively de minimis: lifetime Medicaid revenue is $390 compared with $946.4K in Medicare, so the provider is functionally single-payer in scale with Medicare overwhelmingly dominant. The Medicaid top-3 share is reported at 100.0% of Medicaid revenue, but that total remains negligible in absolute dollars, so Medicaid does not materially contribute to overall revenue.
Medicaid details show a disparity between volume and payment reporting for 88305: the Medicaid table lists 3.2K claims for 88305 with $0 average paid/claim and $0 revenue, while Medicaid revenue is instead recorded against 88312 (42 claims, $5 avg paid/claim, $210 revenue). The 88312 Medicaid activity ranks #36 of 45 in-state (20th percentile) and is described as typical, unremarkable volume, underscoring that reported Medicaid payments are both very small and not a competitive strength.
The provider’s national ranking and percentile labels identify specific statistical outliers: 88305 and 88304 are flagged as notably above typical national volume (88305 rank #203 of 14580, 99th percentile; 88304 rank #126 of 8796, 99th percentile), while many immunostain and consult codes are characterized as typical/unremarkable. These labels reinforce that YALE UNIVERSITY’s distinguishing market position nationally stems from high-volume surgical pathology work rather than broad-based dominance across many laboratory codes.
YALE UNIVERSITY has a long-enumerated presence in the NPI file (enumerated 2006-06-16, ~20 years ago), indicating an established operation with sustained Medicare activity over two decades. Tenure combined with the concentrated revenue mix suggests a stable, specialty-focused lab that relies on longstanding referral patterns for high-complexity surgical pathology 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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 12,000 | $60 | $696.2K |
| 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,… | 650 | $80 | $51.2K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 630 | $80 | $50.3K |
| 88350 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. Code +88350 describes… | 450 | $90 | $39.2K |
| 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… | 590 | $70 | $38.6K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 510 | $40 | $18.4K |
| 88321 | A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received. | 210 | $80 | $16.6K |
| 88346 | The analyst performs an immunofluorescent study using a single antibody stain procedure to detect autoimmune disease or an infectious organism in a tissue or cellular sample. | 120 | $120 | $13.7K |
| 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,… | 90 | $140 | $13.3K |
| 88323 | A qualified provider, typically a pathologist, provides consultation and a report on referred material, such as a tissue block, and prepares and stains slides. A unit of service is the surgical case… | 40 | $90 | $3.6K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 40 | $10 | $210 |
| 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… | 3,230 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
2 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… | 46 | 90 | 3,980 | $40 | $424.8K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 36 | 50 | 470 | $40 | $86.6K |
Other providers in the same ZIP code as Yale University, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Philip M Perrino P.C. | CT | Optometrist | $0 | $4.7M |
| Dva Renal Healthcare Inc | CT | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $4.4M |
| The Connection Inc. | CT | Adult Mental Health Clinic/Center | $0 | $4M |
| Chapel Street Dental P.C. | CT | General Practice Dentistry | $0 | $1.1M |
| Neha Gowali | CT | Diagnostic Radiology Physician | $732.6K | $0 |
| Wei Jie Zhang | CT | Anesthesiology Physician | $496.9K | $7.6K |
| Mariam Totonchy | CT | Dermatology Physician | $488.3K | $0 |
| Nicholas Vu | CT | Diagnostic Radiology Physician | $472.5K | $1.7K |
| Sean Christensen | CT | Dermatology Physician | $441.8K | $0 |
| Christopher Stamey | CT | Dermatology Physician | $413K | $0 |
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