Guilherme Giusti, MD
Hand Surgery · Orange Park, FLNPI 1174903884
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (29.3%), travel and lodging and education — rather than concentrated in one kind of arrangement. 12 manufacturers reported payments, led by Trimed, Inc. at 60.0% of the total. 2025 is the largest year on record at $3,767, 4.4 times the $862 reported in 2019.
Across 25 payments — averaging $273.28 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Trimed, Inc.$4K
- Great Lakes Orthopedics$2K
- Synthes GmbH$612
- Smith+Nephew$144
- Medartis Inc.$143
- Stryker$95
- plus $175 from 6 others
What the payments were for
- Consulting fees$5007%
- Speaking & faculty fees$2,00029%
- Travel & lodging$1,83527%
- Food & beverage$1,07016%
- Education$1,42721%
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 |
|---|---|---|
| Trimed, Inc. | 7 | $4,098 |
| Great Lakes Orthopedics | 4 | $1,565 |
| Synthes GmbH | 2 | $612 |
| Smith+Nephew | 1 | $144 |
| Medartis Inc. | 1 | $143 |
| Stryker | 2 | $95 |
| Integra Lifesciences Corporation | 2 | $38 |
| Anika Therapeutics, Inc. | 1 | $33 |
| Innovation Technologies Inc | 2 | $31 |
| Biocomposites Inc | 1 | $30 |
| Endo USA, Inc. | 1 | $22 |
| Team 1, 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.
- Tools - WFS$3,073
- DYNOMITE$144
- APTUS$143
How this compares
$6,832 in reported general payments places this provider in the 70th 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 |
|---|---|---|
| Methylprednisolone | 18 | $127 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 24 | $112 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Orange Park
- 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.