Ara Bush, MD
Surgery of the Hand · Shelby Township, MINPI 1386959336
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (40.5%), education and travel and lodging — rather than concentrated in one kind of arrangement. 28 manufacturers reported payments, led by Pinnacle, Inc at 27.1% of the total. Reporting peaked in 2019 at $8,401 and has fallen 76.0% since, to $2,016 in 2025. Among surgery of the hand clinicians in MI 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 182 payments — averaging $100.57 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Pinnacle, Inc$5K
- Trimed, Inc.$4K
- Arthrex$3K
- Endo Pharmaceuticals Inc.$1K
- Axogen$1K
- Alafair Biosciences, Inc.$738
- plus $3K from 22 others
What the payments were for
- Consulting fees$5003%
- Speaking & faculty fees$2051%
- Travel & lodging$3,23918%
- Food & beverage$7,42041%
- Education$6,93938%
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 |
|---|---|---|
| Pinnacle, Inc | 12 | $4,967 |
| Trimed, Inc. | 10 | $4,098 |
| Arthrex | 14 | $2,861 |
| Endo Pharmaceuticals Inc. | 60 | $1,437 |
| Axogen | 11 | $1,104 |
| Alafair Biosciences, Inc. | 5 | $738 |
| Stryker | 5 | $578 |
| Skeletal Dynamics Inc | 7 | $477 |
| Amgen(2 entities) | 12 | $417 |
| Endo USA, Inc. | 12 | $328 |
| Integra Lifesciences Corporation | 9 | $283 |
| Aroa Biosurgery Incorporated | 1 | $161 |
| Smith+Nephew | 6 | $115 |
| Musculoskeletal Transplant Foundation Inc. | 1 | $115 |
| Johnson & Johnson | 1 | $108 |
| Acera Surgical, Inc. | 2 | $97 |
| TELA Bio, Inc. | 1 | $82 |
| Medshape, Inc. | 1 | $75 |
| Globus Medical | 1 | $51 |
| Polynovo North America LLC | 2 | $45 |
| Boston Scientific | 2 | $38 |
| Convatec Inc. | 1 | $32 |
| Vertex | 1 | $23 |
| Bioventus LLC | 1 | $18 |
| Acumed LLC | 1 | $16 |
| Osiris Therapeutics Inc. | 1 | $15 |
| Kowa Pharmaceuticals America, Inc. | 1 | $13 |
| Anika Therapeutics, Inc. | 1 | $11 |
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.
- AVANCE NERVE GRAFT$694
- XIAFLEX$679
- VersaWrap$667
- AxoGuard Nerve Connector$258
- AxoGuard Nerve Protector$258
- AXOGUARD HA+ NERVE PROTECTOR$258
- AxoGuard Nerve Cap$258
- VARIAX$254
- T2 ALPHA$164
- FIXOS$138
- BIO4$138
- KRYSTEXXA$132
- Geminus$131
- Align$131
- IJS$131
- Implate$131
- PRIMATRIX$118
- INTEGRA MESHED BILAYER WOUND MATRIX$118
- INTEGRA WOUND MATRIX (IWM)$118
- INTEGRA FLOWABLE WOUND MATRIX$118
How this compares
$18,303 in reported general payments places this provider in the 95th percentile of 41 surgery of the hand providers in Michigan.
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 |
|---|---|---|
| Meloxicam | 51 | $214 |
| Tramadol Hcl | 82 | $176 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 45 | $134 |
| Methylprednisolone | 20 | $95 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 15 | $33 |
Paid to pharmacies, not to this prescriber.
Other surgery of the hand in Shelby Township
- Leslie WongGrand Rapids$185K
- Alberto AvilesWarren$22K
- Emily AbbottWarren$14K
- Michael FitzsimmonsYpsilanti$13K
- Andrew TsaiDetroit$11K
- Caroline WurtzelChelsea$10K
- Edmund GradyWarren$9K
- Marek HansdorferTraverse City$8K
- Edward HaassDearborn$8K
- Avery AroraWest Bloomfield$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.