Cesar Bravo, MD
Hand Surgery · Roanoke, VANPI 1790759645
Payments from drug & device makers
What this record shows
This record is dominated by education: $4,964 of the $6,883 with a category attached, or 72.1%. 7 manufacturers reported payments, led by Supreme Orthopedic Systems, LLC at 44.4% of the total. Reporting peaked in 2019 at $4,277 and has fallen 69.1% since, to $1,323 in 2025.
Across 22 payments — averaging $312.85 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Supreme Orthopedic Systems, LLC$3K
- Fortis Surgical, LLC$2K
- Stryker$833
- Zimmer Biomet$272
- Axogen$194
- Arthrex$150
- plus $23 from 1 others
Across 3 payments — averaging $12,315 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$37K
What the payments were for
- Travel & lodging$69310%
- Food & beverage$1,22618%
- Education$4,96472%
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 |
|---|---|---|
| Supreme Orthopedic Systems, LLC | 1 | $3,053 |
| Fortis Surgical, LLC | 7 | $2,358 |
| Stryker | 7 | $833 |
| Zimmer Biomet | 2 | $272 |
| Axogen | 2 | $194 |
| Arthrex | 2 | $150 |
| Sonex Health, Inc. | 1 | $23 |
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.
How this compares
$6,883 in reported general payments places this provider in the 75th percentile of 81 hand surgery providers in Virginia.
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 |
|---|---|---|
| Amoxicillin | 27 | $91 |
| Methylprednisolone | 14 | $61 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Roanoke
- Peter ApelRoanoke$591
- Lance DavlinNorfolk$165K
- Chad MankeVa Beach$104K
- Frank GwathmeyNorfolk$68K
- Angelo DacusCharlottesville$57K
- Kacy PeekCharlottesville$31K
- Rikesh GandhiArlington$22K
- Nicole SgromoloFort Belvoir$17K
- Jeffrey LovalloArlington$16K
- Drew KiernanLynchburg$15K
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.