From 2014 through 2019, the researchers examined trends in medical industry payments to spine surgeons and all physicians and if specific payments to spine surgeons differ based on firm size. An examination of the publicly available Centers for Medicare and Medicaid Services (CMS) Open Payments Database (OPD) cross-sectional. All US providers were mentioned as receiving industry money, with payments to neurosurgeons and orthopedic spine doctors being investigated further. The quantity and patterns of industry general and research payments and subcategories of general payments, such as royalty/license and consultancy fees, to spine surgeons over 6 years were compared with all physicians. Payment patterns varied among spine device makers, with the greatest reported payments to spine surgeons in 2019. The CMS OPD was examined for publicly available general and research industry payments from 2014 to 2019. Payment patterns for general practitioners were compared with remuneration for neurosurgeons and orthopedic spine surgeons. The payment patterns of the spine device manufacturers who received the most payments in 2019 were researched. To determine statistically significant outcomes, a linear regression analysis was performed. For the inquiry, investigators discovered a total of $42,710,365,196 in general and research payments recorded to all physicians, with spine surgeons receiving 2.6% ($1,112,936,203). Industry payments to spine surgeons declined by 17.5% ($195,571,109 in 2014; $161,283,683 in 2019), whereas payments to all physicians increased by 8.7% ($6,706,208,391 in 2014; $7,288,003,832 in 2019). Industry research payments to spine surgeons have been consistently low, accounting for only 0.5% of all research payments to physicians in 2019. Compared to the constant distribution of payments to all physicians, the median payment received by spine surgeons and the general distribution of payments to the 75th and 95th percentile grew dramatically over the 6 years. In 2014, the top 8 spine device manufacturers received 72.9% of payments from spine surgeons, while payments declined by 17.6% in 2019 ($120,409,083.75, 2014; $99,283,264.49, 2019).