Nathan Shumway
Foot & Ankle Surgery · Council Bluffs, IANPI 1629429451
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (44.2%), travel and lodging and food and beverage — rather than concentrated in one kind of arrangement. 22 manufacturers reported payments, led by Conetic Solutions, Inc. at 41.9% of the total. Reporting peaked in 2022 at $10,289 and has fallen 66.4% since, to $3,455 in 2025. Among foot & ankle surgery clinicians in IA 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 203 payments — averaging $164.07 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Conetic Solutions, Inc.$14K
- Stryker$6K
- Arthrex$4K
- Orthofix Medical, Inc.$3K
- Paragon 28, Inc.$2K
- Gemini Mountain Medical, LLC$2K
- plus $2K from 16 others
What the payments were for
- Travel & lodging$11,96436%
- Food & beverage$6,62620%
- Education$14,71644%
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 |
|---|---|---|
| Conetic Solutions, Inc. | 35 | $13,967 |
| Stryker | 58 | $6,221 |
| Arthrex | 39 | $4,397 |
| Orthofix Medical, Inc. | 8 | $2,612 |
| Paragon 28, Inc. | 15 | $2,355 |
| Gemini Mountain Medical, LLC | 1 | $1,994 |
| Organogenesis Inc. | 9 | $491 |
| Treace Medical Concepts, Inc. | 5 | $451 |
| Smith+Nephew | 11 | $303 |
| Integra Lifesciences Corporation | 6 | $124 |
| Bard Peripheral Vascular, Inc. | 1 | $97 |
| Averitas Pharma Inc. | 4 | $74 |
| Johnson & Johnson | 2 | $67 |
| Innovation Technologies Inc | 1 | $25 |
| Musculoskeletal Transplant Foundation Inc. | 1 | $23 |
| Pacira Pharmaceuticals Incorporated | 1 | $18 |
| Gilead | 1 | $15 |
| Paratek Pharmaceuticals, Inc. | 1 | $15 |
| Mimedx Group, Inc. | 1 | $15 |
| KCI USA, Inc. | 1 | $14 |
| Urgo Medical North America, LLC | 1 | $13 |
| Zimmer Biomet | 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.
- TrueLok Ring Fixation System$3,950
- TL-HEX$2,432
- PROstep$1,615
- INBONE$1,137
- Product Portfolio$1,128
- GRAVITY$978
- HOFFMANN$978
- PROPHECY$908
- XCaliber Articulated Ankle Fixator$759
- AUGMENT INJECTABLE$606
- MONKEY RINGS$535
- ORTHOLOC 2 LAPIFUSE$477
- Portfolio$407
- PuraPly$349
- LAPIPLASTY SYSTEM 1$288
- TRAUMA$232
- OMEGA$173
- 7 X 23MM CITRELOCK IMPLANT$170
- INFINITY$159
- PROSTEP MICA$143
How this compares
$33,306 in reported general payments places this provider in the 90th percentile of 112 foot & ankle surgery providers in Iowa.
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 |
|---|---|---|
| Ciclopirox | 11 | $356 |
| Terbinafine Hcl | 23 | $161 |
| Methylprednisolone | 11 | $68 |
| Meloxicam | 31 | $31 |
Paid to pharmacies, not to this prescriber.
Other foot & ankle surgery in Council Bluffs
- Michael LeeDes Moines$2.1M
- Phinit PhisitkulSioux City$1.4M
- Sean GrambartDes Moines$590K
- Kelsey MillonigDes Moines$330K
- Charles CibulaCedar Falls$38K
- Gregory FooteWaterloo$35K
- Justin RaatzDes Moines$28K
- Tuvi MendelDavenport$26K
- Mica MurdochDes Moines$25K
- John GreavesCherokee$23K
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.