Rafael Lappost, DPM
Foot & Ankle Surgery · Miami Lakes, FLNPI 1104137884
Payments from drug & device makers
What this record shows
The money is spread across several categories — other (47.3%), consulting fees and speaking fees — rather than concentrated in one kind of arrangement. 24 manufacturers reported payments, led by Convatec Inc. at 47.3% of the total. 2025 is the largest year on record at $169,474, 5.6 times the $30,422 reported in 2019. Among foot & ankle surgery clinicians in FL 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 340 payments — averaging $938.01 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Convatec Inc.$151K
- Stryker$131K
- Organogenesis Inc.$31K
- Paragon 28, Inc.$2K
- Treace Medical Concepts, Inc.$1K
- Southern Edge Orthopaedics, Inc.$1K
- plus $2K from 18 others
What the payments were for
- Consulting fees$111,02535%
- Speaking & faculty fees$26,3258%
- Travel & lodging$11,6104%
- Food & beverage$17,9646%
- Education$1,2000%
- Other$150,80047%
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 |
|---|---|---|
| Convatec Inc. | 6 | $150,910 |
| Stryker | 221 | $130,918 |
| Organogenesis Inc. | 46 | $30,574 |
| Paragon 28, Inc. | 16 | $2,183 |
| Treace Medical Concepts, Inc. | 7 | $1,206 |
| Southern Edge Orthopaedics, Inc. | 1 | $1,200 |
| Medshape, Inc. | 4 | $470 |
| Johnson & Johnson | 6 | $315 |
| Polynovo North America LLC | 14 | $275 |
| Bone Support Inc. | 2 | $205 |
| Innovation Technologies Inc | 1 | $193 |
| Ossdsign USA Incorporated | 2 | $116 |
| Smith+Nephew | 2 | $71 |
| Bioventus LLC | 1 | $47 |
| Biocomposites Inc | 1 | $45 |
| Kowa Pharmaceuticals America, Inc. | 2 | $35 |
| Zimmer Biomet | 1 | $32 |
| Acera Surgical, Inc. | 1 | $25 |
| KCI USA, Inc. | 1 | $22 |
| ETS Wound Care LLC | 1 | $20 |
| Access Pro Medical, LLC | 1 | $19 |
| Arthrex | 1 | $16 |
| Mimedx Group, Inc. | 1 | $14 |
| Amniox Medical, 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.
- InnovaMatrix AC$150,910
- HOFFMANN$68,076
- SALVATION$43,318
- VARIAX$39,253
- ANCHORAGE$33,176
- FIXOS$27,877
- ASNIS$27,477
- PROPHECY$17,778
- PROstep$12,861
- INBONE$12,453
- GRAVITY$12,185
- PURAPLY WOUND MATRIX$11,019
- T2$11,000
- STAR$9,338
- NuShield$8,726
- Puraply Antimicrobial$5,642
- PuraPly$5,058
- ALLOWRAP$4,831
- PROLAYER$4,600
- AUGMENT INJECTABLE$4,499
How this compares
$318,924 in reported general payments places this provider in the 95th percentile of 850 foot & ankle 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 |
|---|---|---|
| Ciclopirox | 107 | $2,718 |
| Ammonium Lactate | 95 | $1,571 |
| Ketoconazole | 35 | $565 |
| Terbinafine Hcl | 29 | $355 |
| Methylprednisolone | 46 | $325 |
| Gabapentin | 42 | $292 |
| Celecoxib | 12 | $209 |
| Mupirocin | 16 | $147 |
| Cephalexin | 18 | $109 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 20 | $101 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 19 | $80 |
Paid to pharmacies, not to this prescriber.
Other foot & ankle surgery in Miami Lakes
- David MaiMiami Lakes$180K
- Thomas SangiovanniCoral Gables$2.1M
- Shayne JensenPanama City$1.3M
- Thomas RoukisOrlando$1M
- Craig BreslauerStuart$971K
- Bradley LammWest Palm Beach$861K
- Amber ShaneOrlando$830K
- Jonathan BlumKissimmee$785K
- Mario CalaHialeah$541K
- Christopher ReevesLake Mary$424K
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.