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    v1.0.28
    OpenPayerNPI Medicare & MedicaidSean Toomey
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    Sean Toomey — Billing Profile & Reimbursement Data

    NPI 1003876343 · Seattle, WA · Orthopaedic Surgery Physician

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    Sean Toomey is a orthopaedic surgery physician provider located in Seattle, Washington. This profile covers 16 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
    OrganizationSean Toomey
    Address601 Broadway
    CitySeattle
    StateWA
    ZIP98122
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedMarch 23, 2006

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

    Payer SourceTotal Paid
    Medicare$178.1K
    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.

    16 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    27447In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…70$1,080$73.4K
    27130In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…30$1,080$28K
    27334In this procedure, the provider performs arthrotomy of the knee joint along with anterior or posterior synovectomy to relieve pain and improve gait.70$300$20.7K
    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…140$90$13.3K
    99213The 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…170$70$11.9K
    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$120$7.7K
    73564In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.120$40$5.1K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…50$60$3K
    77073The provider images the lower extremity from hips to ankle to measure the difference in the length of the legs.80$40$2.9K
    73502In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…70$40$2.6K

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    274473532030$1,190$46.3K
    2713012823030$1,060$37.1K
    992143,99910,860100$80$13.6K
    992153,9794,32040$120$8.4K
    2733411040$180$7.9K
    2061112417050$80$6.9K
    992131,8139,69060$60$6.5K
    992041,0214,75030$110$5.2K
    2061035879050$50$3.3K
    7707373030$30$1.8K

    Showing 1–10 of 16

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Lloyd StambaughWADiagnostic Radiology Physician$373.9K$0
    Brian SnitilyWAPhysical Medicine & Rehabilitation Physician$234.1K$0
    Frederick LeeWAOrthopaedic Surgery Physician$231.7K$0
    James CrutcherWAOrthopaedic Surgery Physician$211.7K$0
    Hartley SirkisWADiagnostic Radiology Physician$196.6K$0
    Zachary AshwellWADiagnostic Radiology Physician$183.8K$0
    Jia-wei KoWAOrthopaedic Surgery Physician$177.5K$0
    Neel GuptaWAOrthopaedic Surgery Physician$155.5K$0
    Laura MatsenWAOrthopaedic Surgery Physician$154.7K$0
    Jack FieldsWADiagnostic Radiology Physician$137.8K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Laboratory Corporation Of AmericaWAClinical Medical Laboratory$25M$186.7M
    Swedish Health ServicesWAGeneral Acute Care Hospital$0$125.3M
    Pediatrix Medical Group Of Washington Inc PsWANeonatal-Perinatal Medicine Physician$0$20M
    Planned Parenthood Great Northwest, Hawai'i, Alaska, Indiana, KentuckyWANon-Surgical Family Planning Clinic/Center$0$18.7M
    Advanced Lifeline Services IncWACertified Respiratory Therapist$0$11.1M
    Seattle Emergency Physicians Services Inc PsWAEmergency Medicine Physician$0$7.2M
    Performance Modalities IncWADurable Medical Equipment & Medical Supplies$0$2.8M
    The Polyclinic PLLCWAAmbulatory Surgical Clinic/Center$838.3K$3.5K
    Jason LeeWAVascular Surgery Physician$574.1K$0
    Seattle Hand Surgery Group PCWAAmbulatory Surgical Clinic/Center$322.1K$0

    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. Washington Distribution
    Sean Toomey — 1 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Washington