Nicholas Czosnyka, MD
Surgery · Richland Center, WINPI 1093071441
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 21 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 10 manufacturers reported payments, led by Intuitive Surgical at 30.1% of the total. Reporting peaked in 2023 at $395 and has fallen 70.1% since, to $118 in 2024. That places this record below the midpoint for surgery clinicians in WI, where the typical reported total is $1,305.
Across 21 payments — averaging $50.85 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$321
- Smith+Nephew$220
- Boston Scientific$148
- Davol Inc.$94
- Johnson & Johnson$89
- Stryker$81
- plus $114 from 4 others
What the payments were for
- Food & beverage$1,068100%
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 |
|---|---|---|
| Intuitive Surgical | 4 | $321 |
| Smith+Nephew | 5 | $220 |
| Boston Scientific | 2 | $148 |
| Davol Inc. | 2 | $94 |
| Johnson & Johnson | 2 | $89 |
| Stryker | 2 | $81 |
| Medtronic | 1 | $45 |
| AstraZeneca | 1 | $25 |
| Heron Therapeutics, Inc. | 1 | $24 |
| Amgen | 1 | $20 |
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.
- Da Vinci Surgical System$132
- Grafix PL PRIME$116
- Stravix$116
How this compares
$1,068 in reported general payments places this provider in the 45th percentile of 499 surgery providers in Wisconsin.
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 |
|---|---|---|
| Peg-3350 And ElectrolytesPeg3350/Sod Sulf,bicarb,cl/Kcl | 35 | $537 |
| Peg 3350-ElectrolyteSodium Chloride/Nahco3/Kcl/Peg | 19 | $401 |
| Gavilyte-GPeg3350/Sod Sulf,bicarb,cl/Kcl | 18 | $329 |
| Omeprazole | 20 | $266 |
Paid to pharmacies, not to this prescriber.
Other surgery in Richland Center
- Peter UllrichAppleton$18M
- Matthew GoldblattMilwaukee$594K
- Raymond GeorgenNeenah$325K
- Cynthia GeocarisGreen Bay$263K
- Rana HigginsMilwaukee$148K
- Mustafa BadruddujaKenosha$134K
- Geoffrey RoelantEau Claire$118K
- Peter JanuChilton$113K
- Manfred ChiangBrookfield$110K
- Ryan JuzaMadison$94K
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.