Ryan Kostka, DO
Surgical Critical Care · Fort Worth, TXNPI 1023472107
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (53.9%), food and beverage and speaking fees — rather than concentrated in one kind of arrangement. Intuitive Surgical accounts for 91.4% of it on its own, with 18 other manufacturers making up the rest. Reporting peaked in 2024 at $18,084 and has fallen 90.4% since, to $1,735 in 2025. Among surgical critical care clinicians in TX 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 114 payments — averaging $262.70 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$27K
- Medical Device Business Services, Inc.$815
- Kerecis Limited$815
- Johnson & Johnson$197
- Atricure, Inc.$169
- Kls-martin L.p.$162
- plus $433 from 13 others
What the payments were for
- Speaking & faculty fees$3,50012%
- Travel & lodging$3,05210%
- Food & beverage$7,21524%
- Education$16,15054%
- Gifts$310%
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 | 70 | $27,358 |
| Medical Device Business Services, Inc. | 6 | $815 |
| Kerecis Limited | 8 | $815 |
| Johnson & Johnson(2 entities) | 3 | $197 |
| Atricure, Inc. | 3 | $169 |
| Kls-martin L.p. | 3 | $162 |
| Pfizer | 5 | $81 |
| Stryker | 1 | $56 |
| Integra Lifesciences Corporation | 3 | $47 |
| Smith+Nephew | 1 | $39 |
| AstraZeneca | 2 | $35 |
| AbbVie | 2 | $32 |
| Aroa Biosurgery Incorporated | 1 | $27 |
| Davol Inc. | 1 | $26 |
| Access Pro Medical, LLC | 1 | $26 |
| CSL Behring | 1 | $19 |
| Nestle Healthcare Nutrition Inc. | 1 | $16 |
| Merck | 1 | $15 |
| Medtronic | 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.
How this compares
$29,948 in reported general payments places this provider in the 90th percentile of 104 surgical critical care providers in Texas.
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.
Other surgical critical care in Fort Worth
- Caesar RicciFort Worth$27K
- Ashleigh FontenotFort Worth$26K
- Rahul RasheedFort Worth$15K
- Michelle HagopianFort Worth$11K
- Rejesh GandhiFort Worth$8K
- Sarah ShawFort Worth$7K
- Christopher DaiFort Worth$2K
- Daniel ZieglerFort Worth$2K
- Matthew PerrymanFort Worth$2K
- Samir AwadHouston$1.6M
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.