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NPI 1922259753 · Lenexa, KS · Clinical Medical Laboratory
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Boston Heart Diagnostics Corporation is a clinical medical laboratory provider located in Lenexa, Kansas. This profile covers 94 Medicare and 82 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 | Boston Heart Diagnostics Corporation |
| Address | 18000 W 99th St Ste 200 |
| City | Lenexa |
| State | KS |
| ZIP | 66219 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 10, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $10.4M |
| Medicare | $9.1M |
BOSTON HEART DIAGNOSTICS CORPORATION reports $9.1M in lifetime Medicare revenue and $10.4M in lifetime Medicaid revenue and has an NPI enumerated on 2008-10-10 (~18 years ago), indicating nearly two decades of billing activity across federal payers. The presence of material volume on both Medicare and Medicaid means analysts should treat this as a multi-payer laboratory rather than a single-payer clinic.
Medicare billing is concentrated in specialized biomarker and metabolic assays: the provider’s top three Medicare codes (83698, 83876, 83921) account for 29.0% of its Medicare revenue, with 83698 at 17.6K claims and $793.9K revenue, 83876 at 14.2K claims and $710.2K revenue, and 83921 at 29.4K claims and $617.8K revenue. This mix points to a service-line focused on cardiovascular/inflammatory markers and organic acid testing rather than only routine chemistry panels.
The provider is a national-volume outlier on numerous Medicare tests, frequently ranking at or near the top of peer lists: 83876 ranks #1 of 41 nationally (100th percentile; extreme outlier), 83921 ranks #1 of 178 (100th percentile; extreme outlier), and 83698 ranks #2 of 73 (99th percentile; extreme outlier). Those rankings suggest the organization functions at scale for several niche assays and is a major national supplier for those specific tests.
Medicaid revenue is highly concentrated in COVID-19 testing: U0003, U0005, and 86769 together account for 90.9% of the provider’s Medicaid revenue, with U0003 alone representing 136.8K claims and $8.2M revenue (81.2% of Medicaid revenue). That concentration indicates Medicaid activity is largely driven by high-throughput SARS-CoV-2 molecular testing rather than the broader panel of specialty assays seen on the Medicare side.
The provider’s Medicaid competitive standing in-state is also focused on pandemic testing: U0003 ranks #2 of 47 in-state (98th percentile; extreme outlier) and U0005 ranks #2 of 28 (96th percentile; notably above typical). In contrast, some non-COVID Medicaid codes where the provider appears (for example, 86769 and 83519) show top in-state ranks but much smaller dollar impact, reinforcing that COVID testing dominates Medicaid volume and competitive footprint.
Although Medicaid and Medicare totals are of similar scale ($10.4M Medicaid vs $9.1M Medicare), the risk profile differs: Medicaid revenue is heavily dependent on a single code family (U0003/U0005/86769) while Medicare revenue is distributed across many specialty assays. That asymmetric concentration means payer-specific demand or policy changes (especially for COVID testing reimbursement) would disproportionately affect Medicaid revenue.
Beyond the top Medicare codes, the provider reports high-volume billing across a wide set of metabolic, lipid, hormonal, and inflammatory assays (examples include 83704, 82306, 83090, 83520, 83722), with many of those codes labeled as "extreme outlier" or "notably above typical" in national rank. This breadth of specialty testing alongside repeated high-percentile rankings is consistent with an operation performing centralized, high-throughput specialty diagnostics rather than only local outpatient laboratory work.
Multiple specific-code labels signal repeated statistical outlier status across payers: Medicare items such as 83876, 83921, 83090, 83519, 83525, 83695, and Medicaid items such as U0003 are described as "extreme outlier" or at the 100th percentile. For payer/provider analysts, these labels underline that the provider is a dominant volume player on multiple niche assays and that benchmarking or contract negotiations should account for unusually high testing volumes on those codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
94 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 83698 | The lab analyst measures the amount of lipoprotein associated phospholipase A2, called Lp PLA2, in the patient specimen. | 17,640 | $50 | $793.9K |
| 83876 | The lab analyst measures the amount of myeloperoxidase, an enzyme present in neutrophils, in the patient specimen. | 14,200 | $50 | $710.2K |
| 83921 | The lab analyst measures the single organic acid analyte ordered, which may be any one of the more than 60 identified organic acid analytes. The specimen type may be serum, plasma, urine, amniotic… | 29,420 | $20 | $617.8K |
| 83704 | The lab analyst performs a test to measure the lipoprotein particle numbers and possibly lipoprotein particle subclasses in blood. | 11,630 | $30 | $395.5K |
| 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… | 11,240 | $30 | $325.8K |
| 83090 | The lab analyst measures the amount of homocysteine, typically in a plasma, serum, or urine sample. Testing is related to many inherited disorders of metabolism as homocysteine is an important amino… | 17,470 | $20 | $314.4K |
| 82542 | The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using column chromatography and possibly mass spectrometry. | 13,460 | $20 | $309.6K |
| 83520 | The lab analyst measures the analyte, which is not an infectious agent antibody or infectious agent antigen, by immunoassay. Use 83520 for procedures that have no specific code assigned for the… | 17,960 | $20 | $305.3K |
| 82725 | The lab analyst measures the nonesterified fatty acids, which usually represent less than 5 percent of the total fatty acids in the serum; this fat is protein bound. | 16,810 | $20 | $302.5K |
| 83722 | The lab analyst performs a test to directly measure the small dense low–density lipoprotein (LDL) cholesterol in a patient specimen. | 8,810 | $30 | $290.8K |
Showing 1–10 of 94
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 94 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.
82 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 136,790 | $60 | $8.2M |
| 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,… | 39,580 | $20 | $752.1K |
| 86769 | The lab analyst performs a multiple–step immunoassay to evaluate the patient’s serum for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), which causes coronavirus disease… | 8,430 | $30 | $227.6K |
| 83519 | The lab analyst measures the analyte in question by radioimmunoassay. Use 83519 for procedures that have no specific analyte assigned code available, but meet the 83519 requirements based on the… | 9,600 | $20 | $211.1K |
| 83921 | The lab analyst measures the single organic acid analyte ordered, which may be any one of the more than 60 identified organic acid analytes. The specimen type may be serum, plasma, urine, amniotic… | 12,960 | $10 | $103.7K |
| 82172 | The lab analyst performs apolipoprotein testing on components of lipoprotein complexes that contain a variety of high, low, and very–low density lipoproteins. The three most important of these… | 5,890 | $10 | $76.6K |
| 83701 | The lab analyst performs high resolution fractionation and measures the amount of blood lipoprotein in a patient specimen. The test may include lipoprotein subclasses, as well. | 6,000 | $10 | $72K |
| 82725 | The lab analyst measures the nonesterified fatty acids, which usually represent less than 5 percent of the total fatty acids in the serum; this fat is protein bound. | 8,730 | $10 | $52.4K |
| 83876 | The lab analyst measures the amount of myeloperoxidase, an enzyme present in neutrophils, in the patient specimen. | 4,810 | $10 | $43.3K |
| 81401 | The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 2 molecular pathology code. | 700 | $60 | $39K |
Showing 1–10 of 82
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
82 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 8 | 10 | 140 | $40 | $854.5K |
| 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… | 2 | 50 | 300 | $60 | $648.3K |
| 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… | 6 | 40 | 150 | $20 | $241.4K |
| 83001 | The lab analyst measures the follicle stimulating hormone level, typically in a serum sample. This hormone, which the pituitary gland produces and excretes into the bloodstream, has a powerful effect… | 4 | 10 | 810 | $10 | $129.4K |
| 82670 | The lab analyst measures the level of total estradiol, an estrogenic hormone, on a specimen such as blood using a method such as liquid chromatography–tandem mass spectrometry (LC–MS/MS) to evaluate… | 3 | 10 | 340 | $20 | $129.4K |
| 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. | 6 | 90 | 100 | $10 | $125.6K |
| 84403 | The lab analyst performs a test to measure total testosterone, typically in patient serum. | 3 | 10 | 1,240 | $20 | $119.8K |
| 84481 | The lab analyst performs a test to measure free T3 in patient blood. | 3 | 10 | 410 | $10 | $118K |
| 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… | 7 | 10 | 250 | $10 | $115.9K |
| 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,… | 2 | 30 | 570 | $20 | $112.7K |
Showing 1–10 of 82
Other providers in the same ZIP code as Boston Heart Diagnostics Corporation, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.