Ramesh Srinivasan, MD
Orthopaedic Surgery · San Antonio, TXNPI 1790902104
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (58.2%), travel and lodging and education — rather than concentrated in one kind of arrangement. Acumed LLC accounts for 69.0% of it on its own, with 22 other manufacturers making up the rest. Reporting peaked in 2019 at $40,274 and has fallen 71.2% since, to $11,618 in 2025. Among orthopaedic surgery clinicians in TX 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 175 payments — averaging $607.02 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Acumed LLC$73K
- Exactech, Inc.$11K
- Skeletal Dynamics Inc$10K
- Arthrex$5K
- Medinc Of Texas$2K
- Turner Imaging Systems, Inc.$2K
- plus $3K from 17 others
Across 5 payments — averaging $1911.35 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.
- Acumed LLC$10K
What the payments were for
- Consulting fees$6,8516%
- Speaking & faculty fees$61,80958%
- Travel & lodging$16,29415%
- Food & beverage$8,0618%
- Education$13,21412%
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 |
|---|---|---|
| Acumed LLC | 66 | $73,309 |
| Exactech, Inc. | 24 | $10,713 |
| Skeletal Dynamics Inc | 18 | $10,058 |
| Arthrex | 20 | $5,229 |
| Medinc Of Texas | 5 | $2,479 |
| Turner Imaging Systems, Inc. | 1 | $1,925 |
| Integra Lifesciences Corporation | 8 | $883 |
| Arthrosurface Incorporated | 2 | $257 |
| Johnson & Johnson | 2 | $193 |
| Axogen | 4 | $190 |
| Mission Medical Distribution, LLC | 4 | $146 |
| Pacira Pharmaceuticals Incorporated | 2 | $137 |
| Endo Pharmaceuticals Inc. | 1 | $122 |
| Checkpoint Surgical, Inc | 1 | $120 |
| Trice Medical, Inc. | 2 | $115 |
| Takeda Pharmaceuticals U.S.A., Inc. | 5 | $100 |
| Stryker | 2 | $78 |
| Vertex | 2 | $59 |
| Pfizer | 2 | $31 |
| Anika Therapeutics, Inc. | 1 | $23 |
| Alafair Biosciences, Inc. | 1 | $22 |
| Assertio Therapeutics, Inc. | 1 | $21 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $18 |
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.
- ACUMED$59,572
- Acu-Loc Wrist Plating System$48,838
- Hand Fracture System$33,732
- Elbow Plating System$31,387
- Anatomic Radial Head System$28,062
- Acutrak Headless Compression Screw System$14,264
- Clavicle Plating System$13,008
- EQUINOXE$10,532
- Geminus$9,715
- Align$9,715
- IJS$9,715
- Implate$9,715
- Polarus 3 Solution$9,217
- Midshaft Forearm Plating System$8,867
- MODULAR HAND SYSTEM$8,298
- Total Wrist Fusion Plating System$7,642
- Osteotomy System$7,642
- Forearm Rod System$2,625
- Smart-C System$1,925
- FREEDOM WRIST$708
How this compares
$106,228 in reported general payments places this provider in the 90th percentile of 1,337 orthopaedic surgery providers in Texas.
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 |
|---|---|---|
| Methylprednisolone | 93 | $648 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 86 | $423 |
| Meloxicam | 162 | $326 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 50 | $188 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 33 | $176 |
| Tramadol Hcl | 19 | $45 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery in San Antonio
- Stephen BurkhartSan Antonio$185.3M
- Michael WirthSan Antonio$4.5M
- Ravi KariaSan Antonio$1.1M
- Charles RockwoodSan Antonio$975K
- Christopher ChaputSan Antonio$959K
- Frank ButtacavoliSan Antonio$866K
- Robert HartzlerSan Antonio$654K
- Bernard MorreySan Antonio$639K
- Animesh AgarwalSan Antonio$408K
- Ralph GarzaSan Antonio$390K
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.