Zackary Gangwer
Foot & Ankle Surgery · Norfolk, NENPI 1962768325
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (38.3%), food and beverage and consulting fees — rather than concentrated in one kind of arrangement. 35 manufacturers reported payments, led by Stryker at 29.7% of the total. Reporting peaked in 2022 at $14,142 and has fallen 58.3% since, to $5,900 in 2025. Among foot & ankle surgery clinicians in NE 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 425 payments — averaging $156.39 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$20K
- Arthrex$14K
- Crossroads Extremity Systems, LLC$8K
- Medical Device Business Services, Inc.$4K
- Conetic Solutions, Inc.$4K
- Ossio Inc$3K
- plus $14K from 29 others
What the payments were for
- Consulting fees$14,22521%
- Travel & lodging$25,47138%
- Food & beverage$18,18227%
- Education$8,58913%
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 |
|---|---|---|
| Stryker | 175 | $19,732 |
| Arthrex | 77 | $13,641 |
| Crossroads Extremity Systems, LLC | 13 | $8,237 |
| Medical Device Business Services, Inc. | 3 | $3,864 |
| Conetic Solutions, Inc. | 38 | $3,653 |
| Ossio Inc | 7 | $3,229 |
| Medline Industries LP | 20 | $2,701 |
| Zimmer Biomet | 25 | $2,430 |
| International Life Sciences | 4 | $2,160 |
| Vilex LLC | 10 | $1,568 |
| Nvision Biomedical Technologies, Inc. | 3 | $1,468 |
| Restor3d, Inc. | 8 | $1,137 |
| Arthrosurface Incorporated | 2 | $704 |
| RSW Medical Company, Inc. | 4 | $683 |
| Johnson & Johnson(2 entities) | 4 | $187 |
| Anika Therapeutics, Inc. | 2 | $168 |
| Musculoskeletal Transplant Foundation Inc. | 1 | $142 |
| Organogenesis Inc. | 1 | $111 |
| Linvatec Corporation | 1 | $100 |
| Integra Lifesciences Corporation | 3 | $63 |
| KCI USA, Inc. | 3 | $60 |
| Biopoly LLC | 1 | $58 |
| Medshape, Inc. | 1 | $46 |
| Heron Therapeutics, Inc. | 2 | $45 |
| Orthofix Medical, Inc. | 4 | $41 |
| Convatec Inc. | 2 | $36 |
| Smith+Nephew | 2 | $33 |
| Amgen(2 entities) | 2 | $26 |
| Treace Medical Concepts, Inc. | 1 | $24 |
| Bioventus LLC | 1 | $24 |
| Vericel Corporation | 1 | $23 |
| Sanara Medtech Inc. | 1 | $22 |
| Innovation Technologies Inc | 1 | $21 |
| Pacira Pharmaceuticals Incorporated | 1 | $17 |
| Baudax Bio 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.
- Medical Implant$2,665
- VARIAX$2,279
- MEDLINE UNITE$2,070
- PROstep$1,938
- ORTHOLOC 3DI$1,892
- INBONE$1,730
- PROPHECY$1,720
- INFINITY$1,644
- ORTHOLOC 2 LAPIFUSE$1,587
- Trigon$1,419
- AUGMENT INJECTABLE$1,132
- T2$1,123
- AXSOS$1,123
- DYNEX$1,088
- INVISION$871
- 1588 HD 3 CHIP CAMERA$712
- HemiCAP MTP Resurfacing$704
- HOFFMANN$672
- Sports Medicine-None$672
- CANNULATED SCREWS$638
How this compares
$66,466 in reported general payments places this provider in the 90th percentile of 43 foot & ankle surgery providers in Nebraska.
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 | 92 | $679 |
| Ondansetron OdtOndansetron | 35 | $403 |
| Pregabalin | 16 | $282 |
| Oxycodone Hcl | 44 | $217 |
| Terbinafine Hcl | 22 | $176 |
| Cyclobenzaprine Hcl | 32 | $129 |
Paid to pharmacies, not to this prescriber.
Other foot & ankle surgery in Norfolk
- Jason BaileyNorfolk$51K
- Blayne McCaffreyNorfolk$2K
- David WatersHastings$214K
- Eric SoLincoln$94K
- Bradley CoppleOmaha$83K
- Joshua VestLincoln$40K
- Robert GreenhagenOmaha$29K
- Patrick NelsonOmaha$28K
- Michael ZimmermanOneill$26K
- Matthew WilliamsonLincoln$22K
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.