Kostas Constantine, MD
Hand Surgery · Fredericksburg, VANPI 1740227230
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $1,190 of the $1,353 with a category attached, or 88.0%. It is spread thinly across 11 manufacturers, the largest accounting for just 22.0% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $563, more than ten times the $45 reported in 2019. That places this record below the midpoint for hand surgery clinicians in VA, where the typical reported total is $3,008.
Across 21 payments — averaging $64.42 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Fortis Surgical, LLC$298
- Linvatec Corporation$193
- Arthrex$186
- Stryker$185
- Axogen$118
- Trimed, Inc.$106
- plus $266 from 5 others
What the payments were for
- Travel & lodging$16212%
- Food & beverage$1,19088%
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 |
|---|---|---|
| Fortis Surgical, LLC | 3 | $298 |
| Linvatec Corporation | 4 | $193 |
| Arthrex | 2 | $186 |
| Stryker(2 entities) | 3 | $185 |
| Axogen | 1 | $118 |
| Trimed, Inc. | 1 | $106 |
| Biocircuit Technologies Inc | 1 | $67 |
| Pacira Pharmaceuticals Incorporated | 1 | $63 |
| Integra Lifesciences Corporation | 1 | $63 |
| Bioventus LLC | 3 | $53 |
| Vertex | 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.
- VARIAX$138
- Tools - WFS$106
How this compares
$1,353 in reported general payments places this provider in the 35th percentile of 81 hand 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 |
|---|---|---|
| Diclofenac Sodium | 77 | $1,398 |
| Celecoxib | 104 | $1,312 |
| Gabapentin | 148 | $927 |
| Calcitonin-SalmonCalcitonin,salmon,synthetic | 12 | $548 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 62 | $430 |
| Meloxicam | 210 | $389 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 67 | $354 |
| Methylprednisolone | 54 | $351 |
| Prednisone | 102 | $215 |
| Tramadol Hcl | 73 | $208 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 27 | $177 |
| Cephalexin | 75 | $143 |
| Oxycodone Hcl | 18 | $128 |
| Hydromorphone Hcl | 25 | $109 |
| Ibuprofen | 21 | $100 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Fredericksburg
- Ali HashemiFredericksburg$11K
- Raymond ChungFredericksburg$3K
- Lance DavlinNorfolk$165K
- Chad MankeVa Beach$104K
- Frank GwathmeyNorfolk$68K
- Angelo DacusCharlottesville$57K
- Kacy PeekCharlottesville$31K
- Rikesh GandhiArlington$22K
- Nicole SgromoloFort Belvoir$17K
- Jeffrey LovalloArlington$16K
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.