Nabil Munfakh, MD
Thoracic Surgery (Cardiothoracic Vascular Surgery) · Saint Louis, MONPI 1578634226
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $28,059 of the $44,407 with a category attached, or 63.2%. It is spread thinly across 43 manufacturers, the largest accounting for just 20.8%. Reporting peaked in 2019 at $14,860 and has fallen 70.7% since, to $4,358 in 2025. Among thoracic surgery (cardiothoracic vascular 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 407 payments — averaging $109.11 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Baxter Healthcare$9K
- Abiomed$8K
- Atricure, Inc.$8K
- Edwards Lifesciences$4K
- Abbott$3K
- Lexington Medical, Inc.$2K
- plus $10K from 37 others
What the payments were for
- Consulting fees$8,42019%
- Speaking & faculty fees$2000%
- Travel & lodging$7,71417%
- Food & beverage$28,05963%
- Gifts$140%
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 |
|---|---|---|
| Baxter Healthcare | 16 | $9,222 |
| Abiomed | 93 | $8,228 |
| Atricure, Inc. | 61 | $7,747 |
| Edwards Lifesciences | 44 | $3,647 |
| Abbott | 26 | $2,949 |
| Lexington Medical, Inc. | 6 | $2,257 |
| Intuitive Surgical | 18 | $2,024 |
| Medtronic(2 entities) | 30 | $1,938 |
| Kls-martin L.p. | 15 | $1,029 |
| Artivion, Inc. | 9 | $784 |
| Clearflow Inc. | 6 | $743 |
| Lemaitre Vascular, Inc. | 1 | $500 |
| Angiodynamics, Inc. | 4 | $438 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 19 | $357 |
| Philips North America LLC | 4 | $352 |
| Cvrx, Inc. | 2 | $263 |
| Corcym Inc | 5 | $209 |
| Cardiac Dimensions, Inc. | 2 | $205 |
| Elite Orthopedics, LLC | 6 | $138 |
| Globus Medical | 1 | $132 |
| Nevro Corp. | 1 | $123 |
| LSI Solutions Inc | 4 | $123 |
| Zimmer Biomet | 6 | $114 |
| AstraZeneca | 1 | $112 |
| Johnson & Johnson | 4 | $103 |
| AbbVie | 1 | $100 |
| Sanofi | 1 | $100 |
| Integra Lifesciences Corporation | 3 | $99 |
| KCI USA, Inc. | 2 | $83 |
| Davol Inc. | 2 | $33 |
| BD | 1 | $30 |
| Livanova USA, Inc. | 2 | $30 |
| Solventum Corporation | 1 | $28 |
| Amgen | 1 | $23 |
| Octapharma USA, Inc. | 1 | $22 |
| Bristol Myers Squibb | 1 | $19 |
| Getinge USA Sales, LLC | 1 | $18 |
| Kiniksa Pharmaceuticals International, PLC | 1 | $17 |
| Inari Medical, Inc. | 1 | $16 |
| Biom'up France SAS | 1 | $16 |
| Cumberland Pharmaceuticals, Inc. | 1 | $16 |
| Bayer | 1 | $11 |
| Veran Medical Technologies, Inc. | 1 | $6 |
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.
- No Related Product$8,333
- Impella$6,227
- EPI-SENSE GUIDED COAGULATION SYSTEM WITH VISITRAX$3,336
- Aeon Endostapler & Echelon Flex Powered Stapler$2,150
- ATRICLIP LAA EXCLUSION SYSTEM$1,750
- Trifecta GT Tissue Heart Valve$1,715
- Da Vinci Surgical System$1,474
- SYNERGY ABLATION SYSTEM$1,140
- MITRIS RESILIA Mitral Valve$1,042
- Avalus$887
- ATRICURE CRYOICE CRYOSPHERE CRYOABLATION SYSTEM$811
- INSPIRIS RESILIA aortic valve$805
- PleuraFlow$660
- ATRICURE ATRICLIP LAA EXCLUSION$507
- ATRICURE CRYOSURGICAL SYSTEM$507
- ARTEGRAFT VASCULAR GRAFT$500
- ATRICURE SYNERGY ABLATION SYSTEM$479
- ON-X AORTIC HEART VALVE WITH CONFORM-X SEWING RING AND EXTENDED HOLDER$457
- MitraClip$344
- ATRICURE CRYOICE CRYOABLATION SYSTEM (CRYO2)$288
How this compares
$44,407 in reported general payments places this provider in the 90th percentile of 113 thoracic surgery (cardiothoracic vascular surgery) providers in Missouri.
See all thoracic surgery (cardiothoracic 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 |
|---|---|---|
| Oxycodone Hcl | 60 | $301 |
Paid to pharmacies, not to this prescriber.
Other thoracic surgery (cardiothoracic vascular surgery) in Saint Louis
- Tsuyoshi KanekoSaint Louis$353K
- Ralph DamianoSaint Louis$134K
- Puja KachrooSaint Louis$57K
- Umraan AhmadSaint Louis$51K
- Shuddhadeb RaySaint Louis$38K
- Joshua BakerSaint Louis$36K
- Alexander BresciaSaint Louis$35K
- Kunal Deepak KotkarSaint Louis$33K
- George PattersonSaint Louis$23K
- Muhammad MasoodSaint Louis$23K
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.