Lorenzo Pacelli, MD
Hand Surgery · la Jolla, CANPI 1457315178
Payments from drug & device makers
What this record shows
The money is spread across several categories — royalties or licence payments (30.5%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 23 manufacturers reported payments, led by Integra Lifesciences Corporation at 36.1% of the total. Reporting peaked in 2019 at $15,215 and has fallen 90.0% since, to $1,519 in 2025. Among hand surgery clinicians in CA with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 138 payments — averaging $333.38 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Integra Lifesciences Corporation$17K
- In2bones USA, LLC$9K
- Ensemble Orthopedics, Inc$6K
- Impactortho, Inc.$4K
- Linvatec Corporation$3K
- Smith+Nephew$3K
- plus $4K from 17 others
What the payments were for
- Royalty or licence$14,01130%
- Consulting fees$13,29929%
- Speaking & faculty fees$2,2005%
- Travel & lodging$6,37514%
- Food & beverage$5,20411%
- Education$4,91711%
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 |
|---|---|---|
| Integra Lifesciences Corporation | 26 | $16,601 |
| In2bones USA, LLC | 17 | $9,366 |
| Ensemble Orthopedics, Inc | 30 | $6,466 |
| Impactortho, Inc. | 4 | $4,057 |
| Linvatec Corporation | 11 | $2,757 |
| Smith+Nephew | 8 | $2,749 |
| Arthrex | 4 | $1,617 |
| Johnson & Johnson | 6 | $475 |
| Stryker(2 entities) | 4 | $379 |
| Endo Pharmaceuticals Inc. | 8 | $288 |
| Illuminoss Medical, Inc. | 1 | $171 |
| Skeletal Dynamics Inc | 2 | $169 |
| Acumed LLC | 2 | $158 |
| Medartis Inc. | 3 | $151 |
| Acera Surgical, Inc. | 2 | $130 |
| Endo USA, Inc. | 1 | $128 |
| Anika Therapeutics, Inc. | 1 | $106 |
| Sonex Health, Inc. | 1 | $63 |
| Elevate Surgical Co | 2 | $51 |
| DJO, LLC | 2 | $47 |
| Axogen | 1 | $38 |
| Zimmer Biomet | 1 | $23 |
| Trevena, Inc. | 1 | $17 |
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.
- FREEDOM WRIST$10,122
- TITAN-SHOULDER$10,122
- NUGRIP$8,204
- External Fixation System$7,922
- REVERSE SHOULDER$7,000
- CoLink$6,459
- Ensemble CMC$5,822
- CoLag$3,750
- TSS$2,200
- Cadence$2,200
- MCP$2,200
- ALLOAID$1,923
- AlloAid Allograft$1,390
- PYRO MCP$922
- TSSM - TOTAL SHOULDER SYSTEM METAL$922
- ALLOGRAFT TISSUE$557
- RIGIDLOOP$430
- HEALIX KNOTLESS PEEK$292
- MILAGRO$281
- ACUMED$249
How this compares
$46,007 in reported general payments places this provider in the 90th percentile of 249 hand surgery providers in California.
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 | 36 | $196 |
| Gabapentin | 16 | $177 |
| Ibuprofen | 36 | $152 |
| Cefadroxil | 25 | $109 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in la Jolla
- Steven ShinLos Angeles$2.8M
- Amy LaddStanford$1.4M
- Emilie CheungStanford$1.1M
- Andrew HartmanOceanside$957K
- Nancy LynchSan Mateo$862K
- Jeffrey YaoRedwood City$622K
- Prosper BenhaimLos Angeles$492K
- Wayne PanOakland$423K
- Nathan HoekzemaClovis$400K
- Robin KamalStanford$343K
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.