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NPI 1144437476 · West Lawn, PA · Dermatology Physician
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Daniel Shurman is a dermatology physician provider located in West Lawn, Pennsylvania. This profile covers 30 Medicare and 5 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 | Individual |
| Organization | Daniel Shurman |
| Address | 2128 Penn Avenue |
| City | West Lawn |
| State | PA |
| ZIP | 19609 |
| Taxonomy | Dermatology Physician |
| NPI Enumerated | May 17, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.9M |
| Medicaid | $38.5K |
This provider is effectively Medicare-dominant: total Medicare revenue is $2.9M compared with total Medicaid revenue of $38.5K, so the commercial scale of their Medicare billing far exceeds Medicaid on file. The differential indicates the provider’s financial footprint is concentrated in the Medicare population rather than in Medicaid-covered services.
Medicare revenue is heavily concentrated in a small set of surgical codes: the top three Medicare codes by revenue account for 62.6% of this provider's total Medicare revenue, led by Mohs surgery codes 17311, 17312, and 17313. These three codes reflect the clinic’s core surgical volume and drive the majority of Medicare dollars.
The code mix for Medicare indicates a high-volume Mohs and reconstructive practice: 17311, 17312, and 17313 (Mohs surgery) are the largest contributors, complemented by adjacent tissue transfer/reconstruction codes such as 14040, 14021, 14020, and 14041, and pathology support via 88305. Together this pattern is consistent with a practice that performs extensive staged excisions followed by complex closures and associated pathology processing.
On competitive standing for Medicare Mohs work, this provider ranks at the top nationally — 17312 ranks #2 of 2770 providers nationally (100th percentile; extreme outlier), 17311 ranks #4 of 2969 (100th percentile; extreme outlier), and 17313 ranks #4 of 2300 (100th percentile; extreme outlier) — indicating a nationally outsized Mohs volume relative to peers. Several reconstructive codes also appear well above typical national volume (for example, 14040 ranks #17 of 1131 providers nationally, 98th percentile; extreme outlier), reinforcing that this provider is a major regional/national operator for complex skin cancer surgery and repair.
Medicaid billing is concentrated in evaluation & management visits: the top three Medicaid codes (99214, 99204, 99203) together account for 90.5% of the provider’s total Medicaid revenue, with 99214 alone responsible for $18.4K (47.6% of Medicaid revenue) and 99204 contributing $13.2K (34.1% of Medicaid revenue). These figures show Medicaid activity is primarily office-based E/M encounters rather than the high-value surgical procedures dominating Medicare.
The provider’s Medicaid competitive position is modest in-state: 99214 ranks #4148 of 8157 providers in-state (49th percentile; typical, unremarkable volume), 99204 ranks #578 of 1414 providers in-state (59th percentile; typical), and 99203 ranks #1061 of 1616 providers in-state (34th percentile; typical). That ranking profile indicates routine Medicaid office-visit volumes rather than a leading statewide surgical presence on the Medicaid side.
Ancillary pathology revenue supports the surgical practice on Medicare: 88305 accounts for $208.4K and 7.3% of Medicare revenue and ranks #793 of 14580 providers nationally (95th percentile; typical, unremarkable volume), showing consistent pathology processing aligned with high Mohs throughput. The mix of high-value surgical codes plus pathology reimbursement is operationally coherent for a Mohs-centered dermatology practice.
The provider has an established tenure in the NPI registry (enumerated 2007-05-17, approximately 19 years ago), which—combined with extreme national outlier status on multiple Mohs codes—suggests a long-standing, high-volume surgical dermatology practice rather than a recent or transient operation.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
30 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 1,740 | $480 | $830K |
| 17312 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 2,080 | $320 | $659.7K |
| 17313 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 740 | $400 | $293.7K |
| 17314 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 770 | $300 | $233.3K |
| 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… | 4,090 | $50 | $208.4K |
| 14040 | The provider repairs lesions in the patient’s forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, and/or feet by using healthy tissues from an adjacent site. This code… | 250 | $580 | $144K |
| 14021 | The provider repairs lesions in the patient’s scalp, arms, or legs by using the healthy tissues from an adjacent site. This code represents a defect of 10.1 cm2 to 30.0 cm2. | 150 | $660 | $97.8K |
| 14020 | The provider repairs the defects in the patient’s scalp, arms, and/or legs by using healthy tissues from an adjacent site. This code represents services for defects of 10 cm2 or less. | 170 | $530 | $89.9K |
| 14041 | The provider replaces the lesions in the forehead, cheeks, chin, mouth, neck, axillae or armpits, genitalia, hands, or feet with the healthy tissues from an adjacent site. This code represents a… | 120 | $710 | $86.8K |
| 14060 | The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less. | 80 | $580 | $43.6K |
Showing 1–10 of 30
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 30 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
30 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 17311 | 1 | 110 | 250 | $410 | $134.1K |
| 17312 | 1 | 100 | 120 | $310 | $59.9K |
| 88305 | 29 | 620 | 530 | $40 | $50.4K |
| 14020 | 2 | 20 | 40 | $530 | $32.5K |
| 17313 | 1 | 80 | 60 | $420 | $32.4K |
| 14021 | 1 | 20 | 20 | $650 | $29.5K |
| 14040 | 2 | 40 | 20 | $570 | $27K |
| 14041 | 2 | 40 | 20 | $720 | $23.7K |
| 14060 | 8 | 90 | 20 | $580 | $20.9K |
| 13132 | 96 | 110 | 60 | $200 | $18.8K |
Showing 1–10 of 30
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 200 | $90 | $18.4K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 100 | $140 | $13.2K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 40 | $90 | $3.4K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 50 | $70 | $2.9K |
| 11102 | The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. | 10 | $60 | $760 |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 4,148 | 8,160 | 210 | $60 | $68.4K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 6,826 | 8,870 | 240 | $40 | $56.1K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 578 | 1,410 | 60 | $90 | $30.5K |
| 11102 | The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. | 48 | 50 | 90 | $80 | $30.2K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 1,061 | 1,620 | 80 | $60 | $28.4K |
Other providers in the same ZIP code as Daniel Shurman, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Maxim Healthcare Services, Inc. | PA | Home Health Agency | $0 | $17M |
| Western Berks Ambulance Association | PA | Ambulance | $1.3M | $2.5M |
| Jason Hendrix | PA | Dermatology Physician | $1.5M | $0 |
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