Nicholas Butowski, MD
Neurological Surgery · San Francisco, CANPI 1184681009
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $23,684 of the $24,282 with a category attached, or 97.5%. 7 manufacturers reported payments, led by Ipsen Biopharmaceuticals, Inc at 42.5% of the total. Reporting peaked in 2019 at $6,656 and has fallen 59.0% since, to $2,730 in 2025.
Across 25 payments — averaging $971.26 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Ipsen Biopharmaceuticals, Inc$10K
- Servier Pharmaceuticals LLC$4K
- Bayer$4K
- Amgen$4K
- Stemline Therapeutics Inc.$2K
- Jazz Pharmaceuticals Inc.$550
- plus $87 from 1 others
Across 275 payments — averaging $8741.33 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Boston Scientific$707K
- Ipsen Biopharmaceuticals, Inc$638K
- Karyopharm Therapeutics Inc.$259K
- AbbVie$177K
- E.r. Squibb & Sons, L.L.C.$170K
- Sumitomo Pharma America, Inc.$94K
- plus $359K from 9 others
What the payments were for
- Consulting fees$23,68498%
- Travel & lodging$3121%
- Food & beverage$2861%
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 |
|---|---|---|
| Ipsen Biopharmaceuticals, Inc | 10 | $10,323 |
| Servier Pharmaceuticals LLC | 1 | $4,080 |
| Bayer | 3 | $3,709 |
| Amgen | 7 | $3,614 |
| Stemline Therapeutics Inc. | 1 | $1,920 |
| Jazz Pharmaceuticals Inc. | 1 | $550 |
| Boston Scientific | 2 | $87 |
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.
How this compares
$24,282 in reported general payments places this provider in the 75th percentile of 773 neurological surgery providers in California.
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 |
|---|---|---|
| Levetiracetam | 17 | $845 |
| Dexamethasone | 12 | $200 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in San Francisco
- Christopher AmesSan Francisco$7.1M
- Praveen MummaneniSan Francisco$1.1M
- Lee TanSan Francisco$682K
- Jang YoonSan Francisco$227K
- Larry KhooLos Angeles$2.8M
- Samy AbdouSan Diego$2.4M
- Bret AbshireMurrieta$2.3M
- William TaylorSan Diego$2.1M
- Tooraj GravoriEncino$2M
- Ali MesiwalaRancho Cucamonga$1.5M
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.