Troy Gust, MD
Neurological Surgery · Rapid City, SDNPI 1558585927
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 16 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 9 manufacturers reported payments, led by Globus Medical at 46.0% of the total. Reporting peaked in 2022 at $391 and has fallen 95.5% since, to $18 in 2025. That places this record below the midpoint for neurological surgery clinicians in SD, where the typical reported total is $1,868.
Across 16 payments — averaging $58.20 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Globus Medical$428
- Kuros Biosciences USA, Inc$194
- Wenzel Spine, Inc.$154
- Innovation Technologies Inc$41
- Integra Lifesciences Corporation$38
- Portola Pharmaceuticals, LLC$32
- plus $44 from 3 others
What the payments were for
- Food & beverage$931100%
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 |
|---|---|---|
| Globus Medical | 5 | $428 |
| Kuros Biosciences USA, Inc | 2 | $194 |
| Wenzel Spine, Inc. | 2 | $154 |
| Innovation Technologies Inc | 1 | $41 |
| Integra Lifesciences Corporation | 1 | $38 |
| Portola Pharmaceuticals, LLC | 2 | $32 |
| Vertex | 1 | $18 |
| Johnson & Johnson | 1 | $14 |
| Camber Spine Technologies LLC | 1 | $13 |
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.
- Sable$207
How this compares
$931 in reported general payments places this provider in the 30th percentile of 20 neurological surgery providers in South Dakota.
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 neurological surgery in Rapid City
- Jonathan WilsonRapid City$153K
- Bryan WellmanRapid City$4K
- Rodney SamuelsonRapid City$2K
- Tim WattRapid City$186
- Mark MonaskyRapid City$41
- Shawn VuongSioux Falls$39K
- George YangSioux Falls$7K
- Luis Diaz-AguilarDakota Dunes$5K
- Seokchun LimSioux Falls$4K
- Hendrik KlopperDakota Dunes$4K
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.