Gayan de Silva, MD
Vascular Surgery · Saint Louis, MONPI 1508271230
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (52.2%), travel and lodging and education — rather than concentrated in one kind of arrangement. 17 manufacturers reported payments, led by Medtronic at 58.1% of the total. 2025 is the largest year on record at $5,375, more than ten times the $150 reported in 2019.
Across 111 payments — averaging $98.29 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$6K
- W. L. Gore & Associates, Inc.$1K
- Bolton Medical Inc$738
- Penumbra, Inc.$714
- Shockwave Medical, Inc$444
- Inari Medical, Inc.$390
- plus $1K from 11 others
What the payments were for
- Travel & lodging$3,95736%
- Food & beverage$5,69652%
- Education$1,25612%
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 |
|---|---|---|
| Medtronic | 48 | $6,341 |
| W. L. Gore & Associates, Inc. | 20 | $1,134 |
| Bolton Medical Inc | 11 | $738 |
| Penumbra, Inc. | 6 | $714 |
| Shockwave Medical, Inc | 3 | $444 |
| Inari Medical, Inc. | 7 | $390 |
| Medical Device Business Services, Inc. | 1 | $305 |
| Silk Road Medical, Inc. | 4 | $219 |
| Veryan Medical Incorporated | 1 | $185 |
| Abbott | 1 | $116 |
| BD | 1 | $109 |
| Bard Peripheral Vascular, Inc. | 2 | $51 |
| Asahi Intecc USA, Inc. | 1 | $49 |
| Cardiovascular Systems Inc. | 2 | $42 |
| Stryker | 1 | $31 |
| Boston Scientific | 1 | $21 |
| Merck | 1 | $19 |
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.
- ENDURANT IIS$4,459
- C3 Delivery System$761
- Shockwave IVL System with the Shockwave C2 Coronary IVL Catheter$444
- ENROUTE Transcarotid Neuroprotection System$305
- Indigo$295
- HawkOne$290
- Indigo System$256
- Grafts$253
- TREO ABDOMINAL STENT-GRAFT SYSTEM$243
- BioMimics$185
- TurboHawk$173
- FlowTriever$165
- ClotTriever$165
- ENROUTE Enflate Transcarotid RX Balloon Dilatation Catheter$152
- ENROUTE Transcarotid Stent$152
- Penumbra System$150
- RUBY Coil$138
- Diamondback Peripheral$116
- Heli-FX EndoAnchor System$108
How this compares
$10,910 in reported general payments places this provider in the 65th percentile of 92 vascular 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 |
|---|---|---|
| Gabapentin | 12 | $129 |
| ClopidogrelClopidogrel Bisulfate | 11 | $28 |
Paid to pharmacies, not to this prescriber.
Other vascular surgery in Saint Louis
- Jeffrey JimSaint Louis$1.2M
- Brian PetersonSaint Louis$216K
- Luis SanchezSaint Louis$178K
- Catherine WittgenSaint Louis$139K
- John OhmanSaint Louis$113K
- Patrick GeraghtySaint Louis$65K
- Nathan DrozSaint Louis$38K
- Mohamed ZayedSaint Louis$30K
- Vipul KhetarpaulSaint Louis$23K
- Zachary WankenSaint Louis$18K
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.