Rafael Cardona Duran, MD
Neurological Surgery · Guaynabo, PRNPI 1396948840
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (52.4%), travel and lodging and food and beverage — rather than concentrated in one kind of arrangement. Globus Medical accounts for 77.8% of it on its own, with 4 other manufacturers making up the rest. Reporting peaked in 2021 at $19,482 and has fallen 97.5% since, to $490 in 2025. Among neurological surgery clinicians in PR 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 131 payments — averaging $546.55 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Globus Medical$56K
- Alphatec Spine, Inc$16K
- Stryker$153
- Integrity Implants Inc.$145
- Medtronic$43
What the payments were for
- Consulting fees$37,51252%
- Travel & lodging$26,43037%
- Food & beverage$6,84610%
- Education$8091%
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 |
|---|---|---|
| Globus Medical(2 entities) | 86 | $55,696 |
| Alphatec Spine, Inc | 41 | $15,560 |
| Stryker | 1 | $153 |
| Integrity Implants Inc. | 2 | $145 |
| Medtronic | 1 | $43 |
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.
- XLIF$32,241
- TLIF$16,351
- Other - Miscellaneous$10,803
- Bendini$5,912
- MaXcess$5,600
- ALIF$2,140
- Pulse$923
- Invictus MIS$367
- ACP$266
- AMP$190
- RELINE$170
- NAV - SPINEMAP 3D NAVIGATION SOFTWARE AND INSTRUMENTATION$153
- ADIRA$123
- Sable$123
- Hedron$120
- COALITION AGX$120
- COALITION AGX / AGX RP$116
- MARS 3V/3VL$116
- Excelsius3D Imaging System$116
- Hedron C$116
How this compares
$71,598 in reported general payments places this provider in the 95th percentile of 39 neurological surgery providers in Puerto Rico.
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 |
|---|---|---|
| Teriparatide | 15 | $37,559 |
| Evenity (2 Syringes)Romosozumab-Aqqg | 12 | $30,117 |
| Gabapentin | 48 | $878 |
| Mupirocin | 67 | $568 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Guaynabo
- Ivan Cardona CamposGuaynabo$2K
- Rodolfo AlcedoSan Juan$38K
- David LozadaManati$20K
- Samuel Estronza-OjedaCaguas$20K
- Yadira DacostaHumacao$18K
- Rafael Rodriguez-MercadoSan Juan$17K
- Emil Pastrana RamirezFajardo$11K
- Fanor Saavedra PozoSan Juan$11K
- Cesar CarballoSan Juan$9K
- Michael LopezSan Juan$8K
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.