Todd Twiss, MD
Orthopaedic Surgery · Joplin, MONPI 1285856955
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $64,350 of the $91,696 with a category attached, or 70.2%. Exactech, Inc. accounts for 81.7% of it on its own, with 6 other manufacturers making up the rest. Reporting peaked in 2021 at $27,789 and has fallen 63.2% since, to $10,217 in 2025. Among orthopaedic surgery clinicians in MO 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 100 payments — averaging $916.96 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Exactech, Inc.$75K
- Arthrex$14K
- Titan Surgical Group, LLC$3K
- Stryker$288
- Innovation Technologies Inc$150
- Smith+Nephew$106
- plus $15 from 1 others
What the payments were for
- Consulting fees$64,35070%
- Speaking & faculty fees$9,50010%
- Travel & lodging$11,03712%
- Food & beverage$5,6096%
- Education$1,2001%
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 |
|---|---|---|
| Exactech, Inc. | 40 | $74,899 |
| Arthrex | 39 | $13,611 |
| Titan Surgical Group, LLC | 14 | $2,626 |
| Stryker | 4 | $288 |
| Innovation Technologies Inc | 1 | $150 |
| Smith+Nephew | 1 | $106 |
| Organogenesis Inc. | 1 | $15 |
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.
- EQUINOXE$73,032
- EXACTECHGPS$1,589
- Irrisept$150
- NA$149
- SHOULDER IMPLANTS SPEEDBRIDGE BIO ANCHORS$108
- AETOS Shoulder System$106
How this compares
$91,696 in reported general payments places this provider in the 90th percentile of 455 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 |
|---|---|---|
| Meloxicam | 123 | $474 |
| Methylprednisolone | 51 | $359 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 26 | $322 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 18 | $233 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 25 | $118 |
| Amoxicillin | 18 | $18 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery in Joplin
- Matthew SmithColumbia$2.9M
- Jay KeenerSaint Louis$2.2M
- John WatsonSaint Louis$1.7M
- Peter ChalmersSaint Louis$603K
- Katherine BurnsBridgeton$491K
- Jeremy StattonLees Summit$457K
- Lionel MetzSaint Louis$428K
- Michael HellmanLees Summit$365K
- Jon CarlsonSaint Louis$354K
- Akin CilKansas City$318K
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.