Nick Gunasayan
Foot & Ankle Surgery · San Luis Obispo, CANPI 1417903337
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (39.0%), consulting fees and food and beverage — rather than concentrated in one kind of arrangement. 34 manufacturers reported payments, led by Biotissue Holdings Inc. at 42.6% of the total. Among foot & ankle surgery clinicians in CA with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 274 payments — averaging $250.04 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Biotissue Holdings Inc.$29K
- Fusion Orthopedics USA, LLC$13K
- Treace Medical Concepts, Inc.$12K
- Smith+Nephew$3K
- Cornerstone Medical Associates, Inc.$2K
- Paragon 28, Inc.$2K
- plus $6K from 28 others
What the payments were for
- Consulting fees$23,80035%
- Speaking & faculty fees$4,5007%
- Travel & lodging$26,73639%
- Food & beverage$13,47520%
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 |
|---|---|---|
| Biotissue Holdings Inc. | 110 | $29,219 |
| Fusion Orthopedics USA, LLC | 8 | $13,410 |
| Treace Medical Concepts, Inc. | 48 | $12,449 |
| Smith+Nephew | 19 | $2,801 |
| Cornerstone Medical Associates, Inc. | 12 | $2,353 |
| Paragon 28, Inc. | 10 | $2,180 |
| Arthrex | 17 | $1,593 |
| Stryker | 10 | $1,100 |
| Anika Therapeutics, Inc. | 2 | $836 |
| Medshape, Inc. | 2 | $752 |
| Orthofix Medical, Inc. | 4 | $252 |
| Bone Support Inc. | 2 | $200 |
| Biogennix, LLC | 1 | $189 |
| International Life Sciences | 1 | $170 |
| Integra Lifesciences Corporation | 2 | $158 |
| Linvatec Corporation | 1 | $128 |
| Trice Medical, Inc. | 1 | $123 |
| Zimmer Biomet | 2 | $90 |
| Johnson & Johnson | 2 | $54 |
| GRT US Holding, Inc. | 2 | $53 |
| Organogenesis Inc. | 2 | $46 |
| Baudax Bio Inc. | 2 | $45 |
| Arthrosurface Incorporated | 2 | $36 |
| Krystal Biotech Inc | 1 | $31 |
| Bioventus LLC | 1 | $31 |
| Heron Therapeutics, Inc. | 1 | $30 |
| Merck | 2 | $29 |
| Amgen | 1 | $27 |
| Mimedx Group, Inc. | 1 | $26 |
| Abbott | 1 | $25 |
| Acell, Inc. | 1 | $22 |
| Medtronic | 1 | $22 |
| Paratek Pharmaceuticals, Inc. | 1 | $18 |
| Pacira Pharmaceuticals Incorporated | 1 | $14 |
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.
- Lapiplasty System$9,090
- NEOX$6,691
- CLARIX$4,200
- Bone Anchors with Arthroscopic Delivery System$1,960
- LAPIPLASTY SYSTEM 1$1,679
- Healicoil$1,183
- Cadence$956
- SHOULDER IMPLANT$792
- DynaNail$752
- Portfolio$703
- Bun-Yo-Matic$516
- Lapiplasty$413
- PROstep$382
- PROSTEP MICA$346
- Q-FIX$339
- INBONE$291
- FOOTPRINT$227
- RAPTORMITE / ULTRABRAID$227
- Agion$189
- TrueLok$180
How this compares
$68,511 in reported general payments places this provider in the 95th percentile of 1,126 foot & ankle 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 |
|---|---|---|
| Terbinafine Hcl | 23 | $187 |
| Cephalexin | 24 | $176 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 12 | $82 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 13 | $79 |
| Gabapentin | 11 | $45 |
Paid to pharmacies, not to this prescriber.
Other foot & ankle surgery in San Luis Obispo
- Lant AbernathySan Luis Obispo$28K
- Eric GizaSacramento$3.6M
- Thomas HarrisPasadena$3M
- Thomas ChangSanta Rosa$2M
- Michael CoughlinSan Francisco$1.6M
- Vladimir ZeetserEncino$677K
- Jason NowakRedding$526K
- Candice BradyCamarillo$462K
- Andrew HsuOrange$456K
- Eric TanLos Angeles$447K
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.