Leon Nesti, MD
Orthopaedic Surgery · Silver Spring, MDNPI 1053428854
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (47.2%), food and beverage and travel and lodging — rather than concentrated in one kind of arrangement. 10 manufacturers reported payments, led by Arthrex at 47.8% of the total. Reporting peaked in 2019 at $1,910 and has fallen 85.1% since, to $285 in 2025. That places this record below the midpoint for orthopaedic surgery clinicians in MD, where the typical reported total is $2,738.
Across 26 payments — averaging $98.00 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$1K
- Supreme Orthopedic Systems, LLC$779
- Stryker$169
- Amgen$119
- Linvatec Corporation$97
- Integra Lifesciences Corporation$69
- plus $95 from 4 others
Across 2 payments — averaging $3942.00 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.
- Axogen$8K
What the payments were for
- Travel & lodging$49820%
- Food & beverage$84733%
- Education$1,20347%
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 |
|---|---|---|
| Arthrex | 2 | $1,219 |
| Supreme Orthopedic Systems, LLC | 6 | $779 |
| Stryker | 2 | $169 |
| Amgen(2 entities) | 6 | $119 |
| Linvatec Corporation | 1 | $97 |
| Integra Lifesciences Corporation | 3 | $69 |
| Endo Pharmaceuticals Inc. | 3 | $43 |
| Boston Scientific | 1 | $25 |
| Endo USA, Inc. | 1 | $16 |
| Orthofix Medical, Inc. | 1 | $12 |
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.
- HIPMAP$124
- COBRA$124
- FLOWPORT CANNULA SYSTEM$124
- IVY AIR$124
- CROSSFLOW PUMP$124
How this compares
$2,548 in reported general payments places this provider in the 45th percentile of 378 orthopaedic surgery providers in Maryland.
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 | 109 | $4,046 |
| Prednisone | 28 | $212 |
| Gabapentin | 12 | $92 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 36 | $87 |
| Tramadol Hcl | 63 | $58 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 12 | $48 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 11 | $32 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery in Silver Spring
- Korboi EvansSilver Spring$23K
- Mark MyersonBaltimore$10.5M
- David DaluryTowson$7.6M
- Anand MurthiBaltimore$3.7M
- Timothy CoddTowson$3.6M
- Khaled KebaishBaltimore$3M
- Michael AinLutherville$1.6M
- Shawn StandardBaltimore$1.4M
- Hamid HassanzadehBethesda$1.1M
- Paul SponsellerBaltimore$958K
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.