James Guyton
Adult Reconstructive Orthopaedic Surgery · Germantown, TNNPI 1861488561
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 90.6% of the total across 14 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. Johnson & Johnson accounts for 72.0% of it on its own, with 4 other manufacturers making up the rest. Reporting peaked in 2020 at $303 and has fallen 76.1% since, to $72 in 2025. That places this record below the midpoint for adult reconstructive orthopaedic surgery clinicians in TN, where the typical reported total is $17,622.
Across 14 payments — averaging $83.38 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$840
- Medacta USA, Inc.$137
- Sanara Medtech Inc.$100
- Innovation Technologies Inc$69
- Kerecis Limited$21
What the payments were for
- Travel & lodging$1099%
- Food & beverage$1,05891%
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 |
|---|---|---|
| Johnson & Johnson | 9 | $840 |
| Medacta USA, Inc. | 1 | $137 |
| Sanara Medtech Inc. | 2 | $100 |
| Innovation Technologies Inc | 1 | $69 |
| Kerecis Limited | 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.
- ATTUNE$358
- GMK SPHERE$137
- ACTIS$109
- Kincise Surgical Automated System$102
How this compares
$1,167 in reported general payments places this provider in the 15th percentile of 27 adult reconstructive orthopaedic surgery providers in Tennessee.
See all adult reconstructive orthopaedic surgery providers in Tennessee →
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 |
|---|---|---|
| Celecoxib | 327 | $6,776 |
| Pregabalin | 73 | $1,183 |
| Mupirocin | 207 | $1,146 |
| Pantoprazole Sodium | 97 | $640 |
| Oxycodone Hcl | 87 | $590 |
| Ondansetron Hcl | 96 | $479 |
| Cephalexin | 100 | $341 |
| Tramadol Hcl | 106 | $270 |
| Amoxicillin | 149 | $269 |
| Diclofenac Sodium | 17 | $214 |
| Methylprednisolone | 27 | $176 |
| Meloxicam | 75 | $169 |
| Clindamycin Hcl | 29 | $93 |
| Gabapentin | 13 | $75 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 18 | $49 |
Paid to pharmacies, not to this prescriber.
Other adult reconstructive orthopaedic surgery in Germantown
- Christopher HollandGermantown$71K
- John CrockarellGermantown$932
- James HarkessGermantown$605
- Cory CalendineFranklin$2.5M
- William KurtzBrentwood$774K
- Conrad IvieKnoxville$609K
- Brian PerkinsonFranklin$229K
- Andrew ShinarNashville$151K
- William CarpenterNashville$146K
- Mark FreemanChattanooga$84K
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.