Richard Tosti, MD
Hand Surgery · Bryn Mawr, PANPI 1124339601
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (48.7%), speaking fees and food and beverage — rather than concentrated in one kind of arrangement. 32 manufacturers reported payments, led by Axogen at 27.9% of the total. Among hand surgery clinicians in PA 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 192 payments — averaging $569.41 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Axogen$31K
- Trimed, Inc.$30K
- Smith+Nephew$29K
- Medical Device Business Services, Inc.$12K
- Acumed LLC$2K
- Liberty Surgical Inc.$1K
- plus $5K from 26 others
What the payments were for
- Consulting fees$53,23649%
- Speaking & faculty fees$31,83129%
- Travel & lodging$9,7499%
- Food & beverage$12,88412%
- Education$1,2461%
- Entertainment$3810%
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 |
|---|---|---|
| Axogen | 36 | $30,525 |
| Trimed, Inc. | 24 | $29,976 |
| Smith+Nephew | 35 | $28,818 |
| Medical Device Business Services, Inc. | 14 | $12,323 |
| Acumed LLC | 24 | $1,784 |
| Liberty Surgical Inc. | 1 | $1,200 |
| Zimmer Biomet | 7 | $884 |
| Integra Lifesciences Corporation | 8 | $479 |
| Stryker(2 entities) | 8 | $443 |
| Anika Therapeutics, Inc. | 3 | $340 |
| Extremity Medical | 2 | $335 |
| Paladin Technology Solutions | 3 | $295 |
| Flower Orthopedics Coporation | 2 | $245 |
| Aptis Medical, LLC | 1 | $243 |
| Skeletal Dynamics Inc | 2 | $231 |
| Arthrosurface Incorporated | 2 | $189 |
| Trice Medical, Inc. | 1 | $167 |
| Johnson & Johnson | 2 | $166 |
| Endo Pharmaceuticals Inc. | 3 | $138 |
| Medartis Inc. | 2 | $138 |
| Alafair Biosciences, Inc. | 1 | $97 |
| Biocircuit Technologies Inc | 1 | $81 |
| Exsomed Corporation | 1 | $31 |
| Globus Medical | 1 | $30 |
| Baxter Healthcare | 1 | $29 |
| Conmed Corporation | 1 | $27 |
| Radius Health, Inc. | 1 | $22 |
| Electronic Waveform Lab, Inc. | 1 | $21 |
| Sonex Health, Inc. | 1 | $20 |
| ERMI LLC | 1 | $20 |
| Polynovo North America LLC | 1 | $18 |
| Orthofix Medical, Inc. | 1 | $8 |
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.
- EVOS$25,713
- AXOGUARD$15,414
- Tools - WFS$15,293
- FAST-FIX$14,668
- AxoGuard Nerve Protector$14,527
- AxoGuard Nerve Connector$14,527
- Hat-Trick$14,506
- EVOS MINI$12,856
- Ascension$12,848
- LCP PLATES & SCREWS$10,930
- AVANCE NERVE GRAFT$8,298
- AXOGUARD HA+ NERVE PROTECTOR$7,850
- AxoGuard Nerve Cap$7,850
- INTEGRA$5,807
- NUGRIP CMC IMPLANT SYSTEM$3,462
- Ascension Silicone PIP$1,812
- ACUMED$1,443
- VA-LCP PLATES & SCREWS$1,049
- InFrame Implant$531
- Tools - AFS$322
How this compares
$109,326 in reported general payments places this provider in the 90th percentile of 110 hand surgery providers in Pennsylvania.
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 |
|---|---|---|
| Ibuprofen | 218 | $834 |
| Cephalexin | 34 | $548 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 108 | $399 |
| Gabapentin | 14 | $171 |
| Tramadol Hcl | 43 | $143 |
| Methylprednisolone | 16 | $86 |
| IbuIbuprofen | 18 | $50 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Bryn Mawr
- Asif IlyasBryn Mawr$295K
- Christopher JonesBryn Mawr$16K
- Thomas GrahamAllentown$1.4M
- Randall CulpPlains$358K
- Arthur OstermanKing Of Prussia$198K
- Meredith OstermanKing Of Prussia$196K
- Adam StrohlPhiladelphia$175K
- Mark BaratzPittsburgh$112K
- Sidney JacobyKing Of Prussia$105K
- Peter TangPittsburgh$85K
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.