Andrew Appel, MD
Orthopaedic Surgery of the Spine · Orlando, FLNPI 1538102124
Payments from drug & device makers
What this record shows
This record is dominated by royalties or licence payments: $121,101 of the $201,288 with a category attached, or 60.2%. Precision Spine, Inc. accounts for 99.8% of it on its own, with 7 other manufacturers making up the rest. Reporting peaked in 2019 at $79,880 and has fallen 100.0% since, to $22 in 2024.
Across 25 payments — averaging $8051.53 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Precision Spine, Inc.$201K
- Si-bone, Inc.$87
- Medtronic$85
- CTL Medical Corporation$63
- DJO, LLC$55
- Johnson & Johnson$44
- plus $37 from 2 others
What the payments were for
- Royalty or licence$121,10160%
- Consulting fees$79,81740%
- Food & beverage$3700%
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 |
|---|---|---|
| Precision Spine, Inc. | 11 | $200,918 |
| Si-bone, Inc. | 5 | $87 |
| Medtronic | 2 | $85 |
| CTL Medical Corporation | 1 | $63 |
| DJO, LLC | 3 | $55 |
| Johnson & Johnson | 1 | $44 |
| Ossdsign USA Incorporated | 1 | $22 |
| Bioventus LLC | 1 | $15 |
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.
- Vault$103,311
- Vault ALIF$97,607
- Interbody-TPLIF Oblique Peek$66,427
- SLC Extended Tab$66,427
How this compares
$201,288 in reported general payments places this provider in the 80th 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 |
|---|---|---|
| Gabapentin | 15 | $132 |
| Meloxicam | 35 | $49 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery of the spine in Orlando
- Anthony CucchiOrlando$697K
- George McBrideOrlando$281K
- Joseph FlynnOrlando$121K
- 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
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.