Rafael Diaz Garcia, MD
Hand Surgery · Miami, FLNPI 1154539740
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (51.0%), speaking fees and food and beverage — rather than concentrated in one kind of arrangement. Smith+Nephew accounts for 60.1% of it on its own, with 31 other manufacturers making up the rest. Reporting peaked in 2023 at $28,491 and has fallen 94.6% since, to $1,536 in 2025. Among hand surgery clinicians in FL 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 164 payments — averaging $435.10 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Smith+Nephew$43K
- Axogen$14K
- TELA Bio, Inc.$8K
- Mid-atlantic Surgical Systems, LLC$1K
- Musculoskeletal Transplant Foundation Inc.$896
- Sientra, Inc.$588
- plus $3K from 26 others
What the payments were for
- Consulting fees$36,36751%
- Speaking & faculty fees$19,21027%
- Travel & lodging$5,9078%
- Food & beverage$8,58912%
- Education$1,2842%
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 |
|---|---|---|
| Smith+Nephew | 65 | $42,861 |
| Axogen | 19 | $14,491 |
| TELA Bio, Inc. | 12 | $7,779 |
| Mid-atlantic Surgical Systems, LLC | 3 | $1,296 |
| Musculoskeletal Transplant Foundation Inc. | 7 | $896 |
| Sientra, Inc. | 5 | $588 |
| Davol Inc. | 1 | $492 |
| Medartis Inc. | 4 | $470 |
| Zimmer Biomet | 3 | $427 |
| Arthrex | 5 | $290 |
| Johnson & Johnson | 4 | $205 |
| Endo USA, Inc. | 3 | $201 |
| Acumed LLC | 2 | $183 |
| Trimed, Inc. | 1 | $152 |
| Mentor Worldwide LLC | 2 | $132 |
| Stryker | 3 | $128 |
| Checkpoint Surgical, Inc | 1 | $110 |
| Avita Medical Americas, LLC | 1 | $100 |
| Medtronic | 1 | $99 |
| Polarityte, Inc. | 4 | $91 |
| Medical Device Business Services, Inc. | 4 | $91 |
| Southern Edge Orthopaedics, Inc. | 1 | $46 |
| AbbVie | 1 | $34 |
| Integra Lifesciences Corporation | 2 | $34 |
| Boston Scientific | 1 | $31 |
| Kerecis Limited | 2 | $29 |
| Amgen | 1 | $21 |
| Orthofix Medical, Inc. | 2 | $21 |
| Medline Industries LP | 1 | $17 |
| Sanara Medtech Inc. | 1 | $17 |
| Tactile Systems Technology Inc | 1 | $14 |
| Misonix Inc | 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.
- RENASYS TOUCH$19,308
- PICO$18,504
- AVANCE NERVE GRAFT$13,929
- AxoGuard Nerve Connector$13,929
- AxoGuard Nerve Protector$13,929
- Oasis$10,220
- ALLEVYN HEEL 10.5CM X 13.5CM CTN 5$9,990
- COLLAGENASE SANTYL$9,270
- Leaf$8,334
- OviTex Reinforced Bioscaffold With Permanent Polymer (OviTex)$5,884
- Grafix$3,690
- VERSAJET II$3,240
- Renasys$2,988
- AXOGUARD HA+ NERVE PROTECTOR$2,535
- AxoGuard Nerve Cap$2,335
- PICO 14$2,184
- Ovitex$1,800
- PICO 7$1,530
- NAVIO$1,260
- SIENTRA HIGH STRENGTH COHESIVE SILICONE GEL BREAST IMPLANT$532
How this compares
$71,357 in reported general payments places this provider in the 90th percentile of 173 hand surgery providers in Florida.
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 |
|---|---|---|
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 13 | $120 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Miami
- Jorge Orbay-CerratoMiami$12.5M
- Francisco RubioMiami$345K
- Maria-Carolina Orbay AranMiami$108K
- Helen Hui-ChouMiami$95K
- Eric BalaguerMiami$58K
- Gil GontreMiami$51K
- Dalibel BravoMiami$9K
- Patrick OwensMiami$6K
- Peter EvansStuart$525K
- Nirav GuptaOcala$491K
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.