Rafael Lemus Rangel, MD
Surgery · Lancaster, CANPI 1609102433
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (45.5%), food and beverage and travel and lodging — rather than concentrated in one kind of arrangement. Intuitive Surgical accounts for 67.1% of it on its own, with 10 other manufacturers making up the rest. Reporting peaked in 2023 at $4,459 and has fallen 96.5% since, to $157 in 2025.
Across 78 payments — averaging $112.61 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$6K
- Davol Inc.$736
- Acell, Inc.$726
- Endogastric Solutions, Inc$552
- AbbVie$328
- Smith+Nephew$214
- plus $331 from 5 others
What the payments were for
- Travel & lodging$1,99023%
- Food & beverage$2,74631%
- Education$4,00046%
- Gifts$471%
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 | 22 | $5,897 |
| Davol Inc. | 14 | $736 |
| Acell, Inc. | 7 | $726 |
| Endogastric Solutions, Inc | 6 | $552 |
| AbbVie(2 entities) | 5 | $328 |
| Smith+Nephew | 13 | $214 |
| Medtronic | 5 | $203 |
| Integra Lifesciences Corporation | 3 | $77 |
| Johnson & Johnson | 1 | $21 |
| W. L. Gore & Associates, Inc. | 1 | $15 |
| Acella Pharmaceuticals, LLC | 1 | $14 |
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$5,175
- PHASIX$512
- STRATTICE$248
- ESOPHYX$229
How this compares
$8,784 in reported general payments places this provider in the 75th percentile of 2,363 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 |
|---|---|---|
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 23 | $182 |
| Ibuprofen | 24 | $88 |
| Ondansetron Hcl | 23 | $77 |
| Cyclobenzaprine Hcl | 17 | $75 |
Paid to pharmacies, not to this prescriber.
Other surgery in Lancaster
- Timothy ChuterSan Francisco$8.8M
- Santiago HorganSan Diego$2.8M
- Rock LiuHayward$1.6M
- David LouriePasadena$1.4M
- Andrea PakulaThousand Oaks$1.4M
- Siew-Ming LeeFresno$1.3M
- Beemen KhalilPalo Alto$1.1M
- John LiphamLos Angeles$942K
- Alexander NedopilLodi$682K
- Barry GardinerSan Ramon$602K
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.