David Hirsch, MD
Hand Surgery · Winter Garden, FLNPI 1104231059
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (37.0%), travel and lodging and food and beverage — rather than concentrated in one kind of arrangement. Arthrex accounts for 66.4% of it on its own, with 17 other manufacturers making up the rest. Reporting peaked in 2021 at $7,980 and has fallen 79.7% since, to $1,622 in 2025.
Across 106 payments — averaging $152.90 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$11K
- Reel Surgical, Inc.$2K
- Skeletal Dynamics Inc$1K
- Integra Lifesciences Corporation$1K
- Acera Surgical, Inc.$164
- Checkpoint Surgical, Inc$120
- plus $453 from 12 others
What the payments were for
- Speaking & faculty fees$2,50015%
- Travel & lodging$5,14632%
- Food & beverage$2,56116%
- Education$6,00037%
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 |
|---|---|---|
| Arthrex | 36 | $10,768 |
| Reel Surgical, Inc. | 9 | $1,886 |
| Skeletal Dynamics Inc | 1 | $1,452 |
| Integra Lifesciences Corporation | 36 | $1,366 |
| Acera Surgical, Inc. | 2 | $164 |
| Checkpoint Surgical, Inc | 2 | $120 |
| Endo USA, Inc. | 5 | $100 |
| Endo Pharmaceuticals Inc. | 5 | $92 |
| Terumo BCT, Inc. | 1 | $56 |
| Dynasplint Systems Inc. | 1 | $42 |
| Orthofix Medical, Inc. | 1 | $31 |
| Smith+Nephew | 1 | $26 |
| Kerecis Limited | 1 | $25 |
| Zimmer Biomet | 1 | $22 |
| Organogenesis Inc. | 1 | $22 |
| Johnson & Johnson | 1 | $18 |
| Joint Active Systems, Inc. | 1 | $15 |
| Heraeus Medical, LLC. | 1 | $5 |
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
$16,207 in reported general payments places this provider in the 80th percentile of 173 hand surgery 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 |
|---|---|---|
| Naproxen | 136 | $538 |
| Oxycodone Hcl | 141 | $255 |
| Meloxicam | 25 | $52 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Winter Garden
- Jorge Orbay-CerratoMiami$12.5M
- Peter EvansStuart$525K
- Nirav GuptaOcala$491K
- Francisco RubioMiami$345K
- Justin ZumstegOrlando$133K
- Maria-Carolina Orbay AranMiami$108K
- Paul PatersonVero Beach$104K
- Helen Hui-ChouMiami$95K
- Philipp StreubelWeston$81K
- Roy CardosoCoral Gables$79K
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.