Greg Howes, MD
Neurological Surgery · Roanoke, VANPI 1801074661
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 96.7% of the total across 66 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 11 manufacturers reported payments, led by Medtronic at 55.4% of the total. Reporting peaked in 2021 at $995 and has fallen 65.0% since, to $348 in 2025.
Across 66 payments — averaging $69.22 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$3K
- Johnson & Johnson$633
- Si-bone, Inc.$296
- Medical Device Business Services, Inc.$264
- Stryker$240
- Kuros Biosciences USA, Inc$212
- plus $391 from 5 others
Across 58 payments — averaging $3336.29 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.
- Medical Device Business Services, Inc.$174K
- Globus Medical$12K
- Medtronic$8K
What the payments were for
- Travel & lodging$982%
- Food & beverage$4,41997%
- Entertainment$511%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
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 |
|---|---|---|
| Medtronic(2 entities) | 34 | $2,532 |
| Johnson & Johnson | 7 | $633 |
| Si-bone, Inc. | 6 | $296 |
| Medical Device Business Services, Inc. | 6 | $264 |
| Stryker | 2 | $240 |
| Kuros Biosciences USA, Inc | 4 | $212 |
| Boston Scientific | 2 | $96 |
| Globus Medical | 2 | $95 |
| Arteriocyte Medical Systems, Inc. | 1 | $68 |
| Ossdsign USA Incorporated | 1 | $68 |
| Biocomposites Inc | 1 | $66 |
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.
- INTELLIS$1,075
- VANTA ADAPTIVESTIM$372
- EVEREST SPINAL SYSTEM$174
- TRUMATCH$142
- MagnetOs$139
- OSTEOCOOL RF ABLATION SYSTEM$134
- VIPER$126
- EXPEDIUM$119
How this compares
$4,568 in reported general payments places this provider in the 60th percentile of 156 neurological 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 |
|---|---|---|
| Gabapentin | 12 | $121 |
| Oxycodone Hcl | 12 | $107 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Roanoke
- Gary SimondsRoanoke$13K
- Eric MarvinRoanoke$12K
- John EntwistleRoanoke$11K
- Sandeep MittalRoanoke$9K
- Jonathan McNealRoanoke$7K
- Mark WitcherRoanoke$4K
- Justin SmithCharlottesville$2.3M
- David VincentVirginia Beach$959K
- Mudit SharmaManassas$714K
- Ryan KelloggCharlottesville$245K
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.