Constantine Toumbis, MD
Orthopaedic Surgery of the Spine · Crystal River, FLNPI 1386781409
Payments from drug & device makers
What this record shows
This record is dominated by royalties or licence payments: $1,624,615 of the $1,625,457 with a category attached, or 99.9%. Hyhte Holdings Inc. accounts for 61.2% of it on its own, with 11 other manufacturers making up the rest. Among orthopaedic surgery of the spine clinicians in FL with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 76 payments — averaging $21,388 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Hyhte Holdings Inc.$995K
- Alphatec Spine, Inc$629K
- Stryker$308
- VB Spine LLC$188
- Medtronic$106
- Spineology Inc.$67
- plus $157 from 6 others
What the payments were for
- Royalty or licence$1,624,615100%
- Food & beverage$8410%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Hyhte Holdings Inc. | 7 | $995,488 |
| Alphatec Spine, Inc | 51 | $629,141 |
| Stryker | 4 | $308 |
| VB Spine LLC | 1 | $188 |
| Medtronic | 5 | $106 |
| Spineology Inc. | 1 | $67 |
| Aesculap Implant Systems, LLC | 1 | $47 |
| Amgen | 2 | $36 |
| Merit Medical Systems Inc | 1 | $24 |
| Si-bone, Inc. | 1 | $24 |
| Convatec Inc. | 1 | $14 |
| Zimmer Biomet | 1 | $13 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- Olympic MIS$775,540
- Solanas$381,370
- Novel$363,705
- Arsenal Degenerative$249,559
- Arsenal Degen$245,549
- Novel SD$80,494
- Novel CIS$47,793
- NA$188
- AUTOPLEX$158
How this compares
$1,625,457 in reported general payments places this provider in the 90th percentile of 159 orthopaedic surgery of the spine providers in Florida.
See all orthopaedic surgery of the spine providers in Florida →
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Diclofenac Sodium-MisoprostolDiclofenac Sodium/Misoprostol | 18 | $1,698 |
| Tizanidine Hcl | 226 | $1,107 |
| Celecoxib | 35 | $1,103 |
| Methylprednisolone | 143 | $1,085 |
| Baclofen | 156 | $762 |
| Meloxicam | 269 | $672 |
| Gabapentin | 38 | $547 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 26 | $274 |
| Diclofenac Sodium | 11 | $214 |
| Methocarbamol | 27 | $192 |
| Cyclobenzaprine Hcl | 23 | $88 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery of the spine in Crystal River
- Harry ShufflebargerMiami$3.5M
- Paul KellerMelbourne$3.4M
- Thomas SweeneySarasota$2.3M
- Geoffrey CronenTampa$2.2M
- James BillysOdessa$1.9M
- Mark DekutoskiDestin$1.8M
- Farhan SiddiqiOdessa$1.7M
- Samuel JosephSafety Harbor$1.7M
- Thomas ErricoMiami$1.6M
- Victor HayesOdessa$1.3M
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.