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    v1.0.28
    OpenPayerNPI Medicare & MedicaidStephen Tolhurst
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    Stephen Tolhurst — Billing Profile & Reimbursement Data

    NPI 1023234655 · Flower Mound, TX · Orthopaedic Surgery of the Spine Physician

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    Stephen Tolhurst is a orthopaedic surgery of the spine physician provider located in Flower Mound, Texas. This profile covers 21 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
    OrganizationStephen Tolhurst
    Address4401 Long Prairie Rd Ste 500
    CityFlower Mound
    StateTX
    ZIP75028
    TaxonomyOrthopaedic Surgery of the Spine Physician
    NPI EnumeratedApril 18, 2007

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

    Payer SourceTotal Paid
    Medicare$355.1K
    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.

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    22612The provider performs arthrodesis, also known as spinal fusion, in the lumbar spine (lower back), to permanently join two vertebrae, the interlocking bones of the spine. The provider applies bone…70$1,120$76.4K
    22845The provider places spinal instrumentation at the front of the spine across two to three vertebral segments to correct a spinal deformity during the course of a spinal surgery, such as a spinal…60$540$29.4K
    22558The provider performs arthrodesis, also known as spinal fusion, in the lower back, to permanently join two vertebrae, the interlocking bones of the spine, to alleviate persistent pain caused by a…50$550$29.1K
    22614The provider performs arthrodesis, also known as spinal fusion, to permanently join two vertebrae, the interlocking bones of the spine. The provider applies bone graft material to fuse the spine. The…100$270$25.9K
    22853The provider inserts a metallic cage or mesh device between two vertebrae and may use screws or flanges to attach it to the front part of the vertebrae; the device maintains the disc space, provides…130$190$24.4K
    22842The provider places spinal instrumentation at the back of the spine across three to six vertebral segments to correct a spinal deformity during the course of a spinal surgery, such as a spinal…40$560$23.5K
    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…160$120$19.1K
    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…300$60$18.9K
    22551A cervical disc is removed through the front of the neck to help ease spinal pain and related symptoms. Fusion is performed to stabilize the vertebrae.10$1,240$17.3K
    22840The provider places spinal instrumentation in the neck across a single interspace (C1–C2) to correct a spinal deformity during the course of a spinal surgery, such as a spinal fusion, or arthrodesis.30$570$15.3K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    21 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    22612320020$1,380$30.5K
    225518514020$1,070$20.3K
    6448322669060$190$18.3K
    9921412,51432,500110$80$17.6K
    6304715934020$510$13.2K
    22558711020$550$13.1K
    226143621040$210$12.4K
    992133,85729,79070$60$8.4K
    228421319020$410$8.3K
    22845210020$400$7.6K

    Showing 1–10 of 21

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Chippenham & Johnston-willis Hospitals IncVAGeneral Acute Care Hospital$0$103.7M
    Hca Health Services Of Virginia IncVAGeneral Acute Care Hospital$0$64.5M
    Columbia/hca John Randolph, Inc.VAGeneral Acute Care Hospital$0$49.1M
    El Paso Healthcare System LtdTXGeneral Acute Care Hospital$0$38.5M
    Spotsylvania Medical Center IncVAGeneral Acute Care Hospital$0$31M
    Mission Health Community Multispecialty Providers, LLCNCInternal Medicine Physician$0$24.1M
    Columbia Medical Center Of Arlington Subsidiary LPTXGeneral Acute Care Hospital$0$21.8M
    Columbia Hospital At Medical City Dallas Subsidiary LPTXGeneral Acute Care Hospital$0$21.5M
    Lewis Gale Physicians LLCVAInternal Medicine Physician$0$20.6M
    Reston Hospital Center LLCVAGeneral Acute Care Hospital$0$14.9M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Charles LeeTXRadiation Oncology Physician$564K$0
    Jon VuTXPain Medicine (Anesthesiology) Physician$492.8K$0
    James HeerwagenTXOrthopaedic Surgery Physician$356.6K$0
    Aamir RaiTXAnesthesiology Physician$334.5K$0
    Aaron SchrayerTXOrthopaedic Trauma Physician$279.1K$0
    John McelroyTXOrthopaedic Surgery of the Spine Physician$272.8K$0
    Audrey MorrisTXFamily Nurse Practitioner$262K$0
    Joseph HagmanTXDiagnostic Radiology Physician$237K$0
    John FairbanksTXUrology Physician$233.6K$0
    Manuj SinghalTXOrthopaedic Surgery Physician$227.8K$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. Texas Distribution
    Stephen Tolhurst — 6 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas