Monica Pecache, MD
Hand Surgery · Louisville, KYNPI 1235749227
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (50.7%), education and food and beverage — rather than concentrated in one kind of arrangement. 16 manufacturers reported payments, led by Axogen at 27.3% of the total. Reporting peaked in 2021 at $5,015 and has fallen 96.2% since, to $189 in 2025. Among hand surgery clinicians in KY 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 54 payments — averaging $198.60 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Axogen$3K
- Alpha Orthopedic Systems$2K
- Skeletal Dynamics Inc$2K
- Encore Medical, LP$1K
- Acumed LLC$987
- Medartis Inc.$380
- plus $830 from 10 others
What the payments were for
- Travel & lodging$5,43751%
- Food & beverage$2,60724%
- Education$2,68025%
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 |
|---|---|---|
| Axogen | 11 | $2,931 |
| Alpha Orthopedic Systems | 5 | $2,420 |
| Skeletal Dynamics Inc | 3 | $1,940 |
| Encore Medical, LP | 12 | $1,237 |
| Acumed LLC | 5 | $987 |
| Medartis Inc. | 5 | $380 |
| Medical Device Business Services, Inc. | 1 | $280 |
| Checkpoint Surgical, Inc | 2 | $162 |
| Biocircuit Technologies Inc | 1 | $109 |
| ETS Wound Care LLC | 1 | $80 |
| Kerecis Limited | 1 | $47 |
| Smith+Nephew | 1 | $47 |
| Endo Pharmaceuticals Inc. | 2 | $35 |
| Endo USA, Inc. | 2 | $29 |
| Polynovo North America LLC | 1 | $24 |
| Integra Lifesciences Corporation | 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.
- AVANCE NERVE GRAFT$2,814
- Geminus$1,940
- Align$1,940
- IJS$1,940
- Implate$1,940
- AxoGuard Nerve Connector$1,706
- AxoGuard Nerve Protector$1,706
- Elbow Plating System$836
- Clavicle Plating System$836
- Scapula Plating System$836
- DJO SURGICAL$617
- Acu-Sinch Repair System$593
- Acutrak Headless Compression Screw System$593
- DJO Surgical AltiVate Reverse$427
- APTUS$268
- Anatomic Radial Head System$243
- Polarus 3 Solution$243
- Checkpoint Stimulators$153
- AXOGUARD HA+ NERVE PROTECTOR$123
- AxoGuard Nerve Cap$123
How this compares
$10,724 in reported general payments places this provider in the 90th 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 | 102 | $514 |
| Cephalexin | 81 | $365 |
| Naproxen | 79 | $140 |
| Clindamycin Hcl | 12 | $93 |
| Tramadol Hcl | 22 | $60 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Louisville
- Amitava GuptaLouisville$175K
- Tuna OzyurekogluLouisville$25K
- Stephanie MerimeeLouisville$16K
- Luke RobinsonLouisville$12K
- Rodrigo Moreno GarciaLouisville$10K
- Michelle PalazzoLouisville$7K
- 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.