Ryan Tonucci, DPM
Foot & Ankle Surgery · Louisville, KYNPI 1437551488
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $3,999 of the $5,557 with a category attached, or 72.0%. It is spread thinly across 26 manufacturers, the largest accounting for just 21.6%. Reporting peaked in 2021 at $1,725 and has fallen 90.5% since, to $163 in 2025.
Across 59 payments — averaging $94.19 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Liberty Surgical Inc.$1K
- Stryker$918
- Kerecis Limited$800
- Paragon 28, Inc.$494
- Bioventus LLC$418
- Smith+Nephew$289
- plus $1K from 20 others
What the payments were for
- Travel & lodging$3586%
- Food & beverage$3,99972%
- Education$1,20022%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
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 |
|---|---|---|
| Liberty Surgical Inc. | 1 | $1,200 |
| Stryker | 13 | $918 |
| Kerecis Limited | 3 | $800 |
| Paragon 28, Inc. | 3 | $494 |
| Bioventus LLC | 5 | $418 |
| Smith+Nephew | 3 | $289 |
| Aroa Biosurgery Incorporated | 1 | $192 |
| Nevro Corp. | 2 | $169 |
| Convatec Inc. | 2 | $158 |
| Paratek Pharmaceuticals, Inc. | 2 | $136 |
| Ossio Inc | 1 | $126 |
| AstraZeneca | 3 | $125 |
| KCI USA, Inc. | 2 | $88 |
| Treace Medical Concepts, Inc. | 2 | $73 |
| Johnson & Johnson | 2 | $65 |
| IBSA Pharma Inc. | 2 | $49 |
| Musculoskeletal Transplant Foundation Inc. | 1 | $45 |
| AbbVie | 2 | $38 |
| Hartmann USA, Inc. | 2 | $34 |
| Bone Support Inc. | 1 | $29 |
| Averitas Pharma Inc. | 1 | $25 |
| Accufix Surgical Inc. | 1 | $22 |
| Tactile Systems Technology Inc | 1 | $19 |
| Synergy Orthopedics, LLC | 1 | $17 |
| Metric Medical Devices, Inc. | 1 | $17 |
| Heron Therapeutics, 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.
- Kerecis Omega3 SurgiClose$1,744
- Kerecis Omega3 Marigen$1,643
- Kerecis Omega3 GraftGuide$615
- Additive Orthopedics$313
- GRAFIX PL$271
- Stravix$271
- PROSTEP MICA$169
- Actishield$169
- 7 X 23MM CITRELOCK IMPLANT$169
- CITREFIX$169
- INBONE$167
- INFINITY$163
- Exogen Ultrasound Bone Healing System$142
- VARIAX$136
- PHANTOM Hindfoot$131
- Grafix XC$130
- STRAVIX PL$130
- CONVATEC INC.$124
- AQUACEL AG$124
- Senza$114
How this compares
$5,557 in reported general payments places this provider in the 60th percentile of 141 foot & ankle surgery providers in Kentucky.
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 foot & ankle surgery in Louisville
- Carl KihmLouisville$89K
- Nicholas LacoLouisville$60K
- Jay LechnerLouisville$29K
- William McGloneLouisville$26K
- Timothy FordLouisville$26K
- Garrett WiremanLouisville$26K
- Jonathan TowarnickiLouisville$22K
- Zachary OgdenLouisville$22K
- Eric GustafsonLouisville$20K
- Nicholas VogelsangLouisville$18K
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.