Alejandro Spiotta, MD
Neurological Surgery · Charleston, SCNPI 1346417359
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $671,396 of the $894,104 with a category attached, or 75.1%. 13 manufacturers reported payments, led by Ischemaview, Inc. at 47.0% of the total. Reporting peaked in 2021 at $233,320 and has fallen 71.2% since, to $67,273 in 2025. Among neurological surgery clinicians in SC with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 356 payments — averaging $2511.53 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Ischemaview, Inc.$420K
- Penumbra, Inc.$213K
- Stryker$152K
- Medical Device Business Services, Inc.$71K
- Terumo Medical Corporation$20K
- Medtronic$8K
- plus $10K from 7 others
Across 74 payments — averaging $9545.61 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Stryker$469K
- Medtronic$117K
- Penumbra, Inc.$62K
- Siemens Medical Solutions USA, Inc.$57K
- Microvention, Inc.$2K
What the payments were for
- Consulting fees$671,39675%
- Speaking & faculty fees$139,61016%
- Travel & lodging$74,8598%
- Food & beverage$8,2391%
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 |
|---|---|---|
| Ischemaview, Inc. | 4 | $420,000 |
| Penumbra, Inc. | 89 | $212,990 |
| Stryker | 135 | $151,888 |
| Medical Device Business Services, Inc. | 54 | $70,875 |
| Terumo Medical Corporation | 19 | $20,414 |
| Medtronic | 22 | $7,956 |
| Siemens Medical Solutions USA, Inc. | 5 | $4,264 |
| Microvention, Inc. | 7 | $3,963 |
| Viz.ai, Inc. | 5 | $776 |
| Biosense Webster, Inc. | 1 | $500 |
| Johnson & Johnson | 13 | $403 |
| Route 92 Medical, Inc. | 1 | $54 |
| Imperative Care, Inc | 1 | $21 |
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.
- Penumbra System$156,615
- SURPASS EVOLVE$82,511
- TRUFILL$51,758
- PULSERIDER$48,358
- INFINITY$37,000
- AXS VECTA 71$29,000
- Penumbra SMART Coil$28,127
- AXS CATALYST 7$27,242
- TR Band$19,850
- RED 72$13,903
- SYNCHRO SELECT$12,000
- Smart Coil$11,413
- AXS INFINITY LS$11,250
- GLIDESHEATH SLENDER$9,959
- Navicross$8,500
- Glidesheath$8,500
- EMBOGUARD$7,242
- React$6,500
- EMBOTRAP II DEVICE$4,483
- Pulsar Vascular PulseRider Aneurysm Neck Reconstruction Device$3,850
How this compares
$894,104 in reported general payments places this provider in the 95th percentile of 114 neurological surgery providers in South Carolina.
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 |
|---|---|---|
| ClopidogrelClopidogrel Bisulfate | 18 | $31 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Charleston
- Jonathan LenaCharleston$110K
- Matthew NealCharleston$65K
- Ramin EskandariCharleston$22K
- Istvan TakacsCharleston$13K
- Nathan RowlandCharleston$13K
- Robert StuartCharleston$10K
- Clayton HaldemanCharleston$9K
- Brian CuddyCharleston$9K
- George KhouryCharleston$8K
- Roberta SefcikCharleston$7K
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.