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NPI 1154425791 · Middletown, NY · Orthopaedic Trauma Physician
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Jose Toro is a orthopaedic trauma physician provider located in Middletown, New York. This profile covers 17 Medicare and 1 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 | Jose Toro |
| Address | 707 E Main St |
| City | Middletown |
| State | NY |
| ZIP | 10940 |
| Taxonomy | Orthopaedic Trauma Physician |
| NPI Enumerated | September 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $63.9K |
| Medicaid | $310 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 27245 | In this procedure, the provider performs an open treatment of a femoral fracture between, around, or below the trochanters. He fixes the fracture using an intramedullary implant, or an implant the… | 30 | $1,100 | $30.9K |
| 23615 | In this procedure, the provider performs an open treatment of a surgical or anatomical neck fracture of the upper end of the humerus. He may or may not use internal fixation implants such as pins or… | 10 | $750 | $8.2K |
| 20680 | Skeletal deformities or injuries such as fractures often require the use of skeletal fixation devices, like pins, rods, wires, bands, or plates, to join skeletal parts and maintain their normal… | 10 | $330 | $4.6K |
| 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 | $80 | $3.5K |
| 73502 | In 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… | 80 | $40 | $2.8K |
| 73610 | In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area. | 70 | $30 | $2.1K |
| 73552 | In this diagnostic procedure, the provider takes an X–ray image of the femur (thigh bone) from a minimum of two projections (directions or angles) to check for fracture, swelling, or other reason for… | 70 | $30 | $2.1K |
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 60 | $30 | $1.7K |
| 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… | 20 | $100 | $1.4K |
| 73110 | The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area. | 40 | $30 | $1.3K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 27245 | 19 | 100 | 20 | $1,040 | $20.7K |
| 99213 | 21,092 | 31,440 | 80 | $70 | $12.1K |
| 20680 | 8 | 20 | 10 | $520 | $7.8K |
| 23615 | 2 | 10 | 10 | $360 | $4.7K |
| 99203 | 9,316 | 11,360 | 30 | $90 | $4.7K |
| 99212 | 4,946 | 7,850 | 30 | $40 | $3.6K |
| 73502 | 447 | 1,550 | 40 | $20 | $1.8K |
| 73030 | 583 | 1,630 | 40 | $20 | $1.5K |
| 73560 | 453 | 900 | 40 | $20 | $1.3K |
| 73110 | 350 | 980 | 30 | $20 | $1.2K |
Showing 1–10 of 17
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.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 10 | $20 | $310 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 17,550 | 19,110 | 360 | $70 | $321K |
Other providers in the same ZIP code as Jose Toro, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Middletown Medical PC | NY | Emergency Medicine Physician | $0 | $49.3M |
| Garnet Health Medical Center | NY | General Acute Care Hospital | $0 | $45.1M |
| Restorative Management Corp | NY | Substance Abuse Rehabilitation Facility | $0 | $18.5M |
| Joseph Racanelli | NY | Diagnostic Radiology Physician | $945.7K | $478.9K |
| Bonnie Seecharran | NY | Cardiovascular Disease Physician | $663K | $15.3K |
| Vivek Patil | NY | Vascular & Interventional Radiology Physician | $654.1K | $2.3K |
| David Lowenkron | NY | Specialist | $594.2K | $21.3K |
| Thomas Eanelli | NY | Radiation Oncology Physician | $568.2K | $390 |
| Jagruti Gohel | NY | Family Medicine Physician | $408.6K | $119.9K |
| Elina Zaretsky | NY | Diagnostic Radiology Physician | $477.4K | $0 |
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