David Macias, MD
Orthopaedic Surgery · Alexandria, VANPI 1326282427
Payments from drug & device makers
Across 96 payments — averaging $270.10 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$18K
- Gentleman Orthopedic Solutions$3K
- Supreme Orthopedic Systems, LLC$3K
- Smith+Nephew$296
- Curvebeam LLC$238
- Globus Medical$173
- plus $603 from 7 others
What the payments were for
- Speaking & faculty fees$9,57537%
- Travel & lodging$3,74014%
- Food & beverage$3,71514%
- Education$8,66133%
- Entertainment$2381%
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 | 49 | $18,238 |
| Gentleman Orthopedic Solutions | 10 | $3,292 |
| Supreme Orthopedic Systems, LLC | 22 | $3,089 |
| Smith+Nephew | 5 | $296 |
| Curvebeam LLC | 1 | $238 |
| Globus Medical | 1 | $173 |
| Stryker | 2 | $145 |
| Medline Industries LP | 1 | $143 |
| Paragon 28, Inc. | 1 | $136 |
| Pacira Pharmaceuticals Incorporated | 1 | $89 |
| Johnson & Johnson | 1 | $45 |
| Exactech, Inc. | 1 | $24 |
| Bioventus LLC | 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.
- Senza$173
- Bone Anchors with Arthroscopic Delivery System$140
- Q-FIX$140
- Product Portfolio$136
- DISTAL EXTREMITIES IMPLANTS SOFT TISSUE ANCHORS$124
- DISTAL EXTREMITIES INSTRUMENTS PERCUTANEOUS FOOT SURGERY SU BURRS$109
- DISTAL EXTREMITIES IMPLANTS FOOT & ANKLE DYNANITE STAPLES$107
- ACCOLADE$104
- Grafix$104
- Stravix$104
How this compares
$25,930 in reported general payments places this provider in the 80th percentile of 473 orthopaedic 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 |
|---|---|---|
| Meloxicam | 25 | $54 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery in Alexandria
- Dale YoungNorth Chesterfield$10.9M
- James DowdVirginia Beach$6.5M
- Mark de BloisNorth Chesterfield$4M
- Cato LaurencinCharlottesville$3.5M
- Randall PeytonSterling$2.9M
- William MihalkoCharlottesville$2.1M
- David MillerNorth Chesterfield$1.8M
- Keith LawhornFairfax$1.8M
- Joshua HerzogNorth Chesterfield$1.5M
- Joseph GonduskyVirginia Beach$1.2M
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.