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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMatthew Shea
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    Matthew Shea — Billing Profile & Reimbursement Data

    NPI 1700270949 · Somerset, KY · Nephrology Physician

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    Matthew Shea is a nephrology physician provider located in Somerset, Kentucky. This profile covers 11 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMatthew Shea
    Address104 Hardin Ln Ste A
    CitySomerset
    StateKY
    ZIP42503
    TaxonomyNephrology Physician
    NPI EnumeratedMarch 25, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$161K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    90960The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…360$250$91.3K
    99214The 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$80$16.7K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…200$60$12K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…120$90$10.3K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…70$130$8.4K
    90935Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…140$50$7.5K
    99204The 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…70$100$7K
    90961The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…20$220$3.3K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…20$100$1.9K
    99231The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…40$40$1.4K

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    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

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    909602100140$260$39.5K
    992336961,80080$90$14.1K
    992142,2187,230110$70$14.1K
    992328402,860100$60$11.6K
    90961718040$220$10.6K
    992236251,94040$130$8.6K
    992136,1417,25080$50$7.7K
    992046113,20030$100$4.8K
    992221,4602,07030$90$4.5K
    9093588040$50$3.1K

    Showing 1–10 of 11

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Matthew Shea, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Josmi JosephNYHospitalist Physician$680.9K$61.4K
    Aalap MajmudarKYInternal Medicine Physician$638.7K$0
    Harold HeltonKYNephrology Physician$166.9K$257.2K
    Mohammad AfzalKYInternal Medicine Physician$110.6K$224.2K
    Iqra SaqibNVInternal Medicine Physician$211.9K$0
    Thejo ChipinapiPAHospitalist Physician$169.5K$0
    Giancarlo AcostaGAAdvanced Heart Failure and Transplant Cardiology Physician$162.3K$0
    John BasarichWIFamily Medicine Physician$159K$0
    Theodore PettleTXGastroenterology Physician$139.8K$0
    Chad CooperWYGastroenterology Physician$133.6K$0

    Nearby Providers

    Other providers in the same ZIP code as Matthew Shea, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Morrland Healthcare LLCKYCommunity/Behavioral Health Agency$0$54.8M
    Applied Behavioral Advancements, LLCKYCommunity/Behavioral Health Agency$0$29.2M
    Protea Behavioral Health Counseling, PLLCKYProfessional Counselor$0$24.4M
    Lake Cumberland Regional Hospital, LLCKYInternal Medicine Physician$0$15.6M
    Cumberland Behavior Group, LLCKYCommunity/Behavioral Health Agency$0$15.2M
    Quest CounselingKYMental Health Counselor$0$12.5M
    Lake Cumberland Recovery, IncKYSubstance Use Disorder Rehabilitation Clinic/Center$0$11.8M
    Achievements Through ActionsKYDevelopmentally Disabled Services Day Training Agency$0$10M
    Lake Cumberland Surgery Center LPKYAmbulatory Surgical Clinic/Center$1M$8.7M
    Adult Day Health, Inc.KYAdult Day Care Clinic/Center$0$8.9M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Kentucky Distribution
    Matthew Shea — 1 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky