Thomas Altstadt, MD
Neurological Surgery · Louisville, KYNPI 1831366392
Payments from drug & device makers
What this record shows
The money is spread across several categories — royalties or licence payments (51.1%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 13 manufacturers reported payments, led by Globus Medical at 54.6% of the total. Reporting peaked in 2019 at $12,326 and has fallen 76.8% since, to $2,866 in 2025. Among neurological surgery clinicians in KY 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 72 payments — averaging $506.56 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Globus Medical$20K
- Medical Device Business Services, Inc.$15K
- Johnson & Johnson$778
- Brainlab, Inc.$336
- Camber Spine Technologies LLC$174
- Zimmer Biomet$174
- plus $565 from 7 others
Across 3 payments — averaging $3824.77 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.
- Vertex$11K
What the payments were for
- Royalty or licence$18,63451%
- Consulting fees$7,80521%
- Travel & lodging$7,38820%
- Food & beverage$2,6457%
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 |
|---|---|---|
| Globus Medical | 32 | $19,913 |
| Medical Device Business Services, Inc. | 14 | $14,533 |
| Johnson & Johnson | 9 | $778 |
| Brainlab, Inc. | 2 | $336 |
| Camber Spine Technologies LLC | 3 | $174 |
| Zimmer Biomet | 3 | $174 |
| Medicrea USA, Corp. | 1 | $128 |
| Amgen | 1 | $127 |
| Medtronic(2 entities) | 3 | $114 |
| Alphatec Spine, Inc | 1 | $92 |
| 4web, Inc. | 1 | $67 |
| Averitas Pharma Inc. | 1 | $19 |
| Stryker | 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.
- MONUMENT$18,634
- Spine & Trauma 3D Navigation$7,505
- VIPER$7,505
- EXPEDIUM$6,588
- ELSA$797
- Teligen$251
- Vivigen MIS Delivery System$159
- PASS-LP$128
- UNiD$128
- EVENITY$127
- Excelsius - GPS$121
- PRESERVE - TLIF$107
- COLONIAL$107
How this compares
$36,472 in reported general payments places this provider in the 90th percentile of 99 neurological 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.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 27 | $829 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 37 | $556 |
| Cyclobenzaprine Hcl | 36 | $161 |
| Meloxicam | 42 | $129 |
| Methylprednisolone | 15 | $51 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Louisville
- Tom YaoLouisville$405K
- Joseph NeimatLouisville$196K
- Maria KoutourousiouLouisville$189K
- Shervin DashtiLouisville$146K
- Shawn AdamsLouisville$73K
- Nathaniel ToopLouisville$56K
- Brian WilliamsLouisville$33K
- Ajmal ZemmarLouisville$32K
- Redi RahmaniLouisville$29K
- Rodrigo Fernandez GajardoLouisville$24K
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.