Tyler Krummenacher, MD
Hand Surgery · Saint Louis, MONPI 1851621460
Payments from drug & device makers
What this record shows
This record is dominated by royalties or licence payments: $20,000 of the $25,655 with a category attached, or 78.0%. Acumed LLC accounts for 84.3% of it on its own, with 7 other manufacturers making up the rest. Reporting peaked in 2020 at $20,272 and has fallen 100.0% since, to $8 in 2023. Among hand 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 19 payments — averaging $1350.26 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Acumed LLC$22K
- Elite Orthopedics, LLC$3K
- Arthrex$700
- Stryker$24
- Johnson & Johnson$16
- Pacira Therapeutics, Inc.$13
- plus $20 from 2 others
What the payments were for
- Royalty or licence$20,00078%
- Consulting fees$1,3595%
- Travel & lodging$1421%
- Food & beverage$3311%
- Education$3,82315%
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 |
|---|---|---|
| Acumed LLC | 8 | $21,631 |
| Elite Orthopedics, LLC | 3 | $3,251 |
| Arthrex | 3 | $700 |
| Stryker | 1 | $24 |
| Johnson & Johnson | 1 | $16 |
| Pacira Therapeutics, Inc. | 1 | $13 |
| Fidia Pharma USA Inc. | 1 | $12 |
| Sonex Health, Inc. | 1 | $8 |
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.
How this compares
$25,655 in reported general payments places this provider in the 90th percentile of 36 hand 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 |
|---|---|---|
| Methylprednisolone | 13 | $121 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 33 | $101 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Saint Louis
- Richard GelbermanSaint Louis$30K
- Wassim MouradSaint Louis$24K
- Robert BellSaint Louis$20K
- Matthew WintertonSaint Louis$10K
- Nathan FisherSaint Louis$10K
- Nathanael OlsonSaint Louis$9K
- Schuyler HalversonSaint Louis$8K
- William FeinsteinSaint Louis$6K
- David StregeSaint Louis$4K
- Colleen GlissonSaint Louis$1K
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.