Michelle Palazzo, MD
Hand Surgery · Louisville, KYNPI 1922008747
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.4% of the total across 108 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 22 manufacturers reported payments, led by RTI Surgical, Inc at 35.4% of the total.
Across 108 payments — averaging $66.55 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- RTI Surgical, Inc$3K
- AbbVie$2K
- Axogen$816
- Sientra, Inc.$483
- Integra Lifesciences Corporation$336
- Smith+Nephew$232
- plus $1K from 16 others
What the payments were for
- Food & beverage$7,14599%
- Education$431%
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 |
|---|---|---|
| RTI Surgical, Inc | 30 | $2,544 |
| AbbVie(2 entities) | 19 | $1,502 |
| Axogen | 11 | $816 |
| Sientra, Inc. | 9 | $483 |
| Integra Lifesciences Corporation | 4 | $336 |
| Smith+Nephew | 7 | $232 |
| Stryker | 1 | $174 |
| Mentor Worldwide LLC | 1 | $151 |
| Boston Scientific | 1 | $131 |
| Polarityte, Inc. | 1 | $119 |
| TELA Bio, Inc. | 2 | $114 |
| Endo Pharmaceuticals Inc. | 8 | $114 |
| Musculoskeletal Transplant Foundation Inc. | 1 | $102 |
| Heron Therapeutics, Inc. | 1 | $100 |
| Acera Surgical, Inc. | 1 | $79 |
| Galderma Laboratories, L.p. | 4 | $56 |
| AstraZeneca | 1 | $43 |
| Kerecis Limited | 1 | $22 |
| Sanara Medtech Inc. | 1 | $21 |
| Endo USA, Inc. | 1 | $18 |
| Polynovo North America LLC | 1 | $17 |
| Skeletal Dynamics Inc | 2 | $13 |
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.
- CORTIVA ALLOGRAFT DERMIS$1,923
- INTEGRA$901
- NATRELLE SALINE-FILLED BREAST IMPLANTS$684
- AVANCE NERVE GRAFT$344
- INTEGRA DERMAL REGENERATION TEMPLATE$300
- PRIMATRIX$300
- SIENTRA HIGH STRENGTH COHESIVE SILICONE GEL BREAST IMPLANT$284
- NATRELLE$237
- SPY-PHI SYSTEM$174
- MENTOR MemoryGel Resterilizable Gel Sizer$151
- ALLOGRAFT$150
- WaveWriter Alpha Prime 16$131
- SkinTE$119
- PICO$102
- RENASYS TOUCH$102
- OviTex Reinforced Bioscaffold With Permanent Polymer (OviTex)$101
How this compares
$7,188 in reported general payments places this provider in the 85th percentile of 56 hand surgery providers in Kentucky.
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 |
|---|---|---|
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 128 | $990 |
| Cephalexin | 44 | $401 |
| Promethazine Hcl | 23 | $59 |
| Diazepam | 15 | $23 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Louisville
- Amitava GuptaLouisville$175K
- Tuna OzyurekogluLouisville$25K
- Stephanie MerimeeLouisville$16K
- Luke RobinsonLouisville$12K
- Monica PecacheLouisville$11K
- Rodrigo Moreno GarciaLouisville$10K
- Jorge Quintero PerezLouisville$7K
- Elkin Galvis LeonLouisville$6K
- Kjell van RoyenLouisville$6K
- Yousif El-GammalLouisville$4K
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.