Nitin Agarwal, MD
Neurological Surgery · Saint Louis, MONPI 1366855249
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (36.9%), consulting fees and food and beverage — rather than concentrated in one kind of arrangement. It is spread thinly across 20 manufacturers, the largest accounting for just 18.5%. 2025 is the largest year on record at $23,246, more than ten times the $1,068 reported in 2019. Among neurological surgery clinicians in MO 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 322 payments — averaging $211.95 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Depuy Synthes Products, Inc.$13K
- Globus Medical$13K
- Medical Device Business Services, Inc.$12K
- Johnson & Johnson$10K
- Synthes GmbH$8K
- Medtronic$7K
- plus $6K from 14 others
Across 16 payments — averaging $19,890 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Medtronic$186K
- Medical Device Business Services, Inc.$132K
What the payments were for
- Consulting fees$21,37731%
- Speaking & faculty fees$2,0003%
- Grants$2,5004%
- Travel & lodging$25,20337%
- Food & beverage$17,16925%
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 |
|---|---|---|
| Depuy Synthes Products, Inc. | 20 | $12,624 |
| Globus Medical(2 entities) | 76 | $12,559 |
| Medical Device Business Services, Inc. | 38 | $11,926 |
| Johnson & Johnson(2 entities) | 77 | $9,525 |
| Synthes GmbH | 12 | $8,290 |
| Medtronic(2 entities) | 58 | $6,851 |
| Alphatec Spine, Inc | 9 | $2,168 |
| Mid-atlantic Surgical Systems, LLC | 10 | $1,539 |
| Si-bone, Inc. | 6 | $761 |
| Stryker | 6 | $680 |
| Nexus Spine, LLC | 1 | $278 |
| Carlsmed, Inc. | 1 | $182 |
| Pacira Pharmaceuticals Incorporated | 1 | $144 |
| Novapproach Spine, LLC | 1 | $141 |
| Amgen | 1 | $140 |
| Kls-martin L.p. | 1 | $125 |
| Alevio, LLC | 1 | $115 |
| Spinal Simplicity, LLC | 1 | $97 |
| Phasor Health, LLC | 1 | $80 |
| Arthrex | 1 | $24 |
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.
- Velys$4,456
- XLIF$3,432
- Excelsius Robotics System$3,088
- INFUSE$2,500
- Other - Miscellaneous$1,839
- MAZOR X SYSTEM$1,391
- CALIBER$1,383
- UNID_PASS$1,085
- ALIF$701
- Pulse$640
- AttraX$495
- ExcelsiusGPS Robotic Navigation System$484
- SURGIFLO Hemostatic Matrix$477
- iFuse Implant$435
- RELINE$415
- MaXcess$294
- PressOn$278
- TLX$277
- SYMPHONY$268
- EXPEDIUM$268
How this compares
$68,249 in reported general payments places this provider in the 90th percentile of 172 neurological surgery providers in Missouri.
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 |
|---|---|---|
| Methocarbamol | 11 | $55 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Saint Louis
- Neill WrightSaint Louis$1.1M
- Wilson RaySaint Louis$586K
- Camilo MolinaSaint Louis$412K
- Paul SantiagoSaint Louis$368K
- Daniel ScodarySaint Louis$278K
- Daniel HafezSaint Louis$273K
- John OgunladeSaint Louis$220K
- Joshua OsbunSaint Louis$98K
- Adewale BakareSaint Louis$81K
- Eric LeuthardtSaint Louis$78K
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.