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NPI 1942601570 · Waltham, MA · Anatomic Pathology & Clinical Pathology Physician
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Quantum Pathology, LLC is a anatomic pathology & clinical pathology physician provider located in Waltham, Massachusetts. This profile covers 31 Medicare and 11 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 | Quantum Pathology, LLC |
| Address | 318 Bear Hill Rd |
| City | Waltham |
| State | MA |
| ZIP | 02451 |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| NPI Enumerated | September 15, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.1M |
| Medicaid | $913.7K |
QUANTUM PATHOLOGY, LLC’s billing mix is consistent with a high-volume anatomic and clinical pathology operation that processes large numbers of surgical specimens and performs specialty stains and molecular assays. The provider’s Medicare and Medicaid top codes are dominated by surgical pathology (88305) and special/immunohistochemical staining (88312, 88342/88341), alongside nucleic-acid amplified tests (87798, 88120), indicating core capabilities in routine surgical pathology, immunostains, and molecular infectious testing.
Revenue concentration is high on both payers: the precomputed top-3 Medicare codes account for 67.0% of the provider’s total Medicare revenue, driven chiefly by 88305 (37.2%), 88312 (18.3%), and 87798 (11.5%). This concentration shows Medicare revenue is heavily dependent on a small number of pathology and molecular codes.
Medicaid revenue is even more concentrated: the precomputed top-3 Medicaid codes account for 86.4% of the provider’s total Medicaid revenue, dominated by 88305 (45.3%) and 88312 (35.7%) with a smaller contribution from 88342 (5.4%). That level of concentration suggests the provider’s Medicaid revenue stream is largely driven by surgical pathology and special stain services.
Payer mix favors Medicare in scale: lifetime Medicare revenue of $3.1M substantially exceeds lifetime Medicaid revenue of $913.7K, so Medicare is the larger single payer relationship on file. Both payers show the same core service lines, but Medicaid revenue is proportionally more dependent on the top two codes (88305 and 88312).
National competitive standing on Medicare shows dominant volume for certain pathology codes: 88305 ranks #51 of 14580 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code) and 88312 ranks #26 of 6966 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). These rankings indicate QUANTUM PATHOLOGY operates at substantially higher national volume for those core pathology services than most peers.
Medicaid competitive standing within Massachusetts is similarly strong for special staining: 88312 ranks #2 of 58 providers in-state (98th percentile; extreme outlier, far above typical state volume for this code), while 88305 ranks #28 of 352 providers in-state (92th percentile; typical, unremarkable volume for this code). This pattern suggests the practice is a top in-state performer for special stains and a high-volume but less singularly dominant surgical pathology vendor.
Several individual CPTs show persistently high percentile placement relative to peers, reinforcing a specialized service footprint: on Medicare, 88342 and 88341 both sit in the upper percentiles (99th) and 88112, 88344, and 88312 are noted as notably or extremely above typical national volume for those codes. On Medicaid the provider’s 88312 position as an extreme outlier and 88313/88311 placements in the 86–91st percentile band confirm a concentrated emphasis on stain and preparatory pathology services across payers.
The NPI was enumerated on 2014-09-15 (~12 years ago), indicating the provider has built these volumes and specialty mix over roughly a decade. Given the concentrated revenue by a few high-volume pathology and molecular codes, the operational profile is consistent with a centralized or reference-style pathology service that has scaled immunostaining and NAAT/molecular testing capacity since enumeration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
31 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… | 25,150 | $50 | $1.1M |
| 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… | 5,500 | $100 | $555.1K |
| 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… | 10,270 | $30 | $349K |
| 88120 | The lab analyst performs a technical lab test on a urinary tract specimen using in situ hybridization and three to five molecular probes for manual morphometric analysis, looking at the number and… | 460 | $520 | $236.8K |
| 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,… | 2,010 | $70 | $144.4K |
| 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… | 2,080 | $70 | $139.2K |
| 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… | 710 | $110 | $75.4K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 930 | $70 | $64.4K |
| 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,… | 470 | $130 | $60.2K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 1,420 | $40 | $54K |
Showing 1–10 of 31
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 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.
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… | 17,130 | $20 | $411.2K |
| 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… | 8,510 | $40 | $323.5K |
| 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,… | 1,650 | $30 | $49.4K |
| 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… | 1,160 | $40 | $48.8K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 1,510 | $30 | $39.3K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 970 | $20 | $23.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 790 | $10 | $4.8K |
| 88311 | The lab analyst performs a decalcification procedure on a specimen. Dissolving the calcium makes it easier to perform certain examinations. | 1,090 | $1 | $4.4K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 150 | $10 | $1.1K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 150 | $10 | $1.1K |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
11 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… | 28 | 350 | 380 | $30 | $118.2K |
| 87481 | The lab analyst performs a test for Candida species using amplified nucleic acid probe technique. | 19 | 50 | 240 | $30 | $117.1K |
| 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… | 20 | 70 | 410 | $30 | $65.3K |
| 87653 | The lab analyst performs a test for Streptococcus, group B, using amplified nucleic acid probe technique. The amplified probe provides a rapid means to assess colonization by Streptococcus, group B,… | 14 | 20 | 1,940 | $30 | $56.8K |
| 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,… | 45 | 130 | 570 | $20 | $35.5K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 22 | 60 | 370 | $20 | $31.6K |
| 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… | 2 | 60 | 150 | $30 | $27.8K |
| 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. | 177 | 350 | 150 | $30 | $20.7K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 6 | 50 | 240 | $10 | $8.4K |
| 87640 | The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique. | 14 | 20 | 260 | $10 | $7.2K |
Showing 1–10 of 11
Other providers in the same ZIP code as Quantum Pathology, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Jewish Family & Children's Service | MA | Foster Care Agency | $0 | $11.6M |
| Exosome Diagnostics, Inc. | MA | Clinical Medical Laboratory | $8.9M | $310.6K |
| Children's Dental Of Waltham, P.C. | MA | General Practice Dentistry | $0 | $7.2M |
| West Suburban Eye Surgery Center LLC | MA | Ophthalmologic Surgery Clinic/Center | $4.9M | $1.2M |
| Boston Eye Surgery & Laser Center Trust | MA | Ambulatory Surgical Clinic/Center | $2.4M | $67.1K |
| Peter Chang | MA | Ophthalmology Physician | $1.3M | $0 |
| Boston Out-patient Surgical Suites, LLC | MA | Ambulatory Surgical Clinic/Center | $693.9K | $0 |
| Stephen Anesi | MA | Ophthalmology Physician | $550.8K | $0 |
| Geoffrey Van Flandern | MA | Orthopaedic Surgery Physician | $408.1K | $0 |
| Ambika Hoguet | MA | Ophthalmology Physician | $375.6K | $0 |
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