David Ruch, MD
Orthopaedic Surgery · Durham, NCNPI 1356438998
Payments from drug & device makers
What this record shows
The money is spread across several categories — royalties or licence payments (40.8%), speaking fees and consulting fees — rather than concentrated in one kind of arrangement. 19 manufacturers reported payments, led by Acumed LLC at 58.8% of the total. Reporting peaked in 2019 at $98,089 and has fallen 63.9% since, to $35,388 in 2025. Among orthopaedic surgery clinicians in NC 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 281 payments — averaging $1143.29 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Acumed LLC$189K
- Anika Therapeutics, Inc.$68K
- Arthrosurface Incorporated$33K
- Osteocentric Technologies, Inc.$22K
- Southtech Orthopedics$3K
- Exsomed Corporation$3K
- plus $3K from 13 others
Across 20 payments — averaging $14,841 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.
- Acumed LLC$247K
- Axogen$50K
What the payments were for
- Royalty or licence$130,97841%
- Consulting fees$61,51819%
- Speaking & faculty fees$97,83330%
- Travel & lodging$19,9286%
- Food & beverage$7,2562%
- Education$3,7141%
- Entertainment$370%
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 |
|---|---|---|
| Acumed LLC | 154 | $188,954 |
| Anika Therapeutics, Inc. | 15 | $68,359 |
| Arthrosurface Incorporated | 17 | $32,721 |
| Osteocentric Technologies, Inc. | 52 | $21,813 |
| Southtech Orthopedics | 4 | $3,457 |
| Exsomed Corporation | 10 | $3,276 |
| Bioventus LLC | 5 | $514 |
| Medartis Inc. | 4 | $443 |
| Checkpoint Surgical, Inc | 3 | $302 |
| Johnson & Johnson | 3 | $252 |
| Integra Lifesciences Corporation | 2 | $232 |
| Alafair Biosciences, Inc. | 2 | $212 |
| Field Orthopaedics Pty Ltd | 1 | $167 |
| Stryker | 2 | $130 |
| Arthrex | 1 | $121 |
| Zimmer Biomet | 3 | $108 |
| Next Science LLC | 1 | $97 |
| Biedermann Motech, Inc. | 1 | $90 |
| Tricoast Surgical Solutions LLC | 1 | $18 |
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.
- ACUMED$139,049
- Acu-Loc Wrist Plating System$86,701
- Hand Fracture System$61,686
- SpeedSpiral$51,833
- Anatomic Radial Head System$45,369
- Elbow Plating System$45,221
- Acutrak Headless Compression Screw System$37,742
- Clavicle Plating System$33,706
- Speed spiral$33,406
- OsteoMed$26,942
- Acu-Loc Wrist Spanning System$20,735
- Polarus 3 Solution$17,060
- SpeedSpiral CMC System$15,064
- Osteotomy System$14,494
- OsteoCentric 4.0 x 130mm LOCKING BONE SCREW FASTENER ST$14,000
- Unifi Technology$7,139
- INnate Implant$2,900
- Total Wrist Fusion Plating System$1,560
- InFrame Implant$1,500
- ArcPhix System$1,500
How this compares
$321,264 in reported general payments places this provider in the 95th percentile of 845 orthopaedic surgery providers in North Carolina.
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.
Other orthopaedic surgery in Durham
- William JiranekDurham$6.4M
- Thomas VailDurham$5.7M
- Mark EasleyDurham$4M
- Michael BolognesiDurham$2.3M
- Christopher BrownDurham$2.3M
- Samuel AdamsDurham$1.8M
- James NunleyDurham$1.6M
- James DeorioDurham$1.3M
- Richard MatherDurham$711K
- Marc RichardDurham$643K
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.