Ryan Nunley, MD
Adult Reconstructive Orthopaedic Surgery · Saint Louis, MONPI 1164568887
Payments from drug & device makers
What this record shows
The money is spread across several categories — royalties or licence payments (48.8%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 13 manufacturers reported payments, led by Medical Device Business Services, Inc. at 34.1% of the total. Among adult reconstructive orthopaedic surgery clinicians in MO 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 875 payments — averaging $4508.08 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medical Device Business Services, Inc.$1.3M
- Depuy Synthes Products, Inc.$1.2M
- Smith+Nephew$897K
- Johnson & Johnson$349K
- Ethicon Endo-surgery Inc.$66K
- Microport Orthopedics Inc$57K
- plus $54K from 7 others
Across 49 payments — averaging $13,923 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.
- Stryker$668K
- Medical Device Business Services, Inc.$15K
What the payments were for
- Royalty or licence$1,926,60449%
- Consulting fees$1,841,24547%
- Speaking & faculty fees$82,4652%
- Travel & lodging$83,6582%
- Food & beverage$10,6020%
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 |
|---|---|---|
| Medical Device Business Services, Inc. | 513 | $1,346,770 |
| Depuy Synthes Products, Inc. | 137 | $1,175,094 |
| Smith+Nephew | 35 | $896,980 |
| Johnson & Johnson(3 entities) | 149 | $348,826 |
| Ethicon Endo-surgery Inc. | 2 | $65,835 |
| Microport Orthopedics Inc | 13 | $57,476 |
| Medtronic(2 entities) | 17 | $49,604 |
| Heron Therapeutics, Inc. | 3 | $3,122 |
| Synthes GmbH | 1 | $500 |
| Medacta USA, Inc. | 1 | $141 |
| Exactech, Inc. | 1 | $100 |
| Biocomposites Inc | 2 | $93 |
| Stryker | 1 | $33 |
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.
- ATTUNE$2,366,182
- NAVIO$855,510
- Velys$365,014
- REAL INTELLIGENCE$356,189
- STRATAFIX$348,436
- DERMABOND Portfolio$185,323
- ACTIS$69,427
- DERMABOND PRINEO$65,835
- MPO Hip System$57,460
- MONOCRYL$55,110
- AQUAMANTYS$49,530
- SURGIFLO Hemostatic Matrix$45,760
- BIRMINGHAM HIP$36,725
- ECHELON ENDOPATH$25,204
- Echelon Flex$25,204
- Enseal X1$25,204
- Echelon Circular$25,204
- SURGIFLO Hemostatic Matrix Family of Products$18,948
- Prineo 42$16,446
- DERMABOND$16,246
How this compares
$3,944,574 in reported general payments places this provider in the 95th percentile of 36 adult reconstructive orthopaedic surgery providers in Missouri.
See all adult reconstructive orthopaedic surgery providers in Missouri →
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 |
|---|---|---|
| EliquisApixaban | 55 | $31,266 |
| Doxycycline Hyclate | 91 | $7,189 |
| Mupirocin | 527 | $3,348 |
| Oxycodone Hcl | 265 | $1,542 |
| Vitamin D2Ergocalciferol (Vitamin D2) | 106 | $1,430 |
| Meloxicam | 481 | $1,323 |
| Tramadol Hcl | 359 | $1,222 |
| Doxycycline Monohydrate | 12 | $1,025 |
| Cefadroxil | 41 | $772 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 29 | $467 |
| Amoxicillin | 404 | $461 |
| Diclofenac Sodium | 22 | $435 |
| Prednisone | 108 | $346 |
| Cyclobenzaprine Hcl | 35 | $264 |
| Cephalexin | 21 | $243 |
Paid to pharmacies, not to this prescriber.
Other adult reconstructive orthopaedic surgery in Saint Louis
- Robert BarrackSaint Louis$10.6M
- John ClohisySaint Louis$538K
- Kimberly BartosiakSaint Louis$92K
- Ilya BendichSaint Louis$78K
- Muyibat AdelaniSaint Louis$71K
- Parth VyasSaint Louis$47K
- Katherine MistrettaSaint Louis$41K
- Gireesh ReddySaint Louis$18K
- Joseph GibianSaint Louis$13K
- Tyler CalkinsSaint Louis$11K
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.