Brian Vial, MD
Hand Surgery · Houston, TXNPI 1295155570
Payments from drug & device makers
Across 49 payments — averaging $118.08 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$2K
- Medinc Of Texas$2K
- Johnson & Johnson$263
- Zimmer Biomet$216
- Smith+Nephew$170
- Extremity Medical$146
- plus $339 from 7 others
What the payments were for
- Travel & lodging$1,10919%
- Food & beverage$2,38541%
- Education$2,29140%
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 | 24 | $2,332 |
| Medinc Of Texas | 3 | $2,318 |
| Johnson & Johnson | 6 | $263 |
| Zimmer Biomet | 6 | $216 |
| Smith+Nephew | 1 | $170 |
| Extremity Medical | 1 | $146 |
| Sanara Medtech Inc. | 1 | $135 |
| Catalyst Orthoscience | 1 | $64 |
| Vertex | 1 | $37 |
| Sonex Health, Inc. | 1 | $34 |
| Integra Lifesciences Corporation | 2 | $34 |
| Endo Pharmaceuticals Inc. | 1 | $19 |
| Kowa Pharmaceuticals America, Inc. | 1 | $16 |
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.
- MAKO$1,322
- ACCOLADE$609
- TRIDENT$501
- AXSOS$501
- TRITANIUM$501
- T-Fix$170
- Journey II BCS$170
- PICO 7 Single Use Negative Pressure Wound Therapy$170
- REDAPT Revision Hip System$170
- T2$157
- CellerateRx$135
- VA-LCP PLATES & SCREWS$117
How this compares
$5,786 in reported general payments places this provider in the 60th percentile of 170 hand surgery providers in Texas.
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 | 303 | $638 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 119 | $632 |
| Methylprednisolone | 35 | $274 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 29 | $181 |
| Tramadol Hcl | 17 | $48 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Houston
- Kourosh JafarniaHouston$278K
- Scott MitchellHouston$97K
- Adil AhmedHouston$30K
- Andrea TianHouston$26K
- Kyle WoernerHouston$18K
- Adam SharHouston$16K
- Darshan PatelHouston$12K
- Ashton MansourHouston$11K
- Mark KhorsandiHouston$10K
- James BennettHouston$10K
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.