Richard Guyer, MD
Orthopaedic Surgery of the Spine · Plano, TXNPI 1174567721
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $490,851 of the $758,409 with a category attached, or 64.7%. It is spread thinly across 36 manufacturers, the largest accounting for just 22.0%. Reporting peaked in 2019 at $162,136 and has fallen 67.1% since, to $53,395 in 2025. Among orthopaedic surgery of the spine 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 558 payments — averaging $1359.16 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Centinel Spine, LLC$167K
- Aesculap Implant Systems, LLC$164K
- Orthofix Medical, Inc.$148K
- Globus Medical$80K
- Nanovis LLC$60K
- Stryker$48K
- plus $91K from 30 others
Across 108 payments — averaging $3848.24 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.
- Globus Medical$302K
- Centinel Spine, LLC$71K
- Aesculap Implant Systems, LLC$37K
- Orthofix Medical, Inc.$6K
Across 17 payments — averaging $8823.53 each. An ownership or investment interest held by the physician or an immediate family member.
- Centinel Spine, LLC$150K
- Stimwave Technologies Incorporated$0
What the payments were for
- Royalty or licence$114,17215%
- Consulting fees$490,85165%
- Speaking & faculty fees$95,50513%
- Travel & lodging$35,3435%
- Food & beverage$19,7873%
- Education$2,7500%
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 |
|---|---|---|
| Centinel Spine, LLC | 105 | $166,675 |
| Aesculap Implant Systems, LLC | 134 | $164,065 |
| Orthofix Medical, Inc. | 90 | $148,111 |
| Globus Medical(2 entities) | 89 | $80,253 |
| Nanovis LLC | 4 | $60,240 |
| Stryker | 20 | $47,691 |
| Medacta USA, Inc. | 2 | $27,150 |
| Zimvie Inc. | 24 | $20,561 |
| Alphatec Spine, Inc | 15 | $12,326 |
| Dymicron | 2 | $7,000 |
| Highridge Medical LLC | 6 | $5,563 |
| Carlsmed, Inc. | 3 | $5,285 |
| Integrity Implants Inc. | 3 | $2,750 |
| Spinecraft, LLC | 1 | $2,000 |
| Axis Spine Technologies Inc. | 9 | $1,874 |
| Medtronic | 2 | $1,596 |
| Surgalign Spine Technologies, Inc. | 24 | $1,100 |
| Aesculap, Inc. | 2 | $1,050 |
| Degen Medical, Inc. | 2 | $471 |
| Innovasis Inc | 2 | $438 |
| Bioventus LLC | 1 | $264 |
| Biocomposites Inc | 2 | $228 |
| Painteq LLC | 1 | $226 |
| Kuros Biosciences USA, Inc | 1 | $206 |
| Augmedics Inc. | 2 | $190 |
| Johnson & Johnson | 1 | $163 |
| Carbofix Spine Inc | 1 | $151 |
| Acuity Surgical Devices, LLC | 1 | $142 |
| Baxter Healthcare | 1 | $121 |
| 4web, Inc. | 1 | $110 |
| Zimmer Biomet | 1 | $97 |
| Alafair Biosciences, Inc. | 1 | $95 |
| Spinal Elements, Inc. | 2 | $91 |
| Pacira Pharmaceuticals Incorporated | 1 | $84 |
| Clariance, Inc. | 1 | $29 |
| Cerapedics Inc. | 1 | $11 |
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.
- M6-C Artificial Cervical Disc$103,101
- ACTIVL$96,913
- PRODISC C$74,174
- Simplify Cervical Artificial Disc$74,052
- PRODISC L$72,520
- ACTIVL ARTIFICIAL DISC$67,122
- ALEUTIAN CERVICAL$33,103
- M6-C$30,354
- MECTALIF$26,700
- PD-Spine-New Product$19,672
- Forticore Interbody Spinal Spacer$16,648
- RHINE$14,452
- OsseoScrew$12,195
- Ascent LE Posterior Occipital Cervico-Thoracic System$8,500
- 3-Degrees Anterior Cervical Plating (ACP) System$8,500
- PSO Instrument Set$8,500
- PILLAR SA PTC Spacer System$8,500
- NGage Surgical Mesh System$8,500
- STALIF M-Ti$7,125
- PRODISC C VIVO$6,644
How this compares
$758,409 in reported general payments places this provider in the 90th percentile of 207 orthopaedic surgery of the spine providers in Texas.
See all orthopaedic surgery of the spine 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.
Other orthopaedic surgery of the spine in Plano
- Michael ObrienPlano$1M
- Scott BlumenthalPlano$833K
- Ralph RashbaumPlano$616K
- Mark ValentePlano$411K
- Jessica ShellockPlano$264K
- Anthony OwusuPlano$149K
- Kendall CarllPlano$138K
- Alexander SatinPlano$83K
- Renato BositaPlano$51K
- Randall DryerAustin$2.9M
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.