Dr. Rafael Rafols, M.D.
What this data tells you about Dr. Rafols
Dr. Rafael Rafols is a family medicine specialist in Edinburg, TX, with 17 years of NPI registration. Based on federal Medicare data, Dr. Rafols performed 1,228 Medicare services across 549 unique beneficiaries.
Between the years covered by Open Payments, Dr. Rafols received a total of $33,521 from 23 pharmaceutical and/or device companies across 335 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in family medicine. The majority of payments are for consulting, which typically reflects recognized clinical expertise sought by manufacturers. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Rafols is Very High — reflecting how much public federal data is available about this provider. This is not a quality rating. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
Medicare Practice Summary
Medicare Utilization ↗Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Nursing facility visit, low complexity A daily follow-up visit for an existing patient in a nursing facility involving straightforward medical decision making. The visit requires at least 15 minutes of time if time is used to determine the level of care. |
249 | $56 | $130 |
| Initial hospital admission, moderate complexity Initial hospital inpatient or observation care for a new patient involving moderate-level medical decision making, with at least 55 minutes total time on the date of the encounter. |
230 | $96 | $260 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
222 | $60 | $185 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
164 | $91 | $195 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
136 | $95 | $177 |
| Skin and tissue removal, 20 sq cm or less This procedure involves the surgical excision of skin and underlying tissue from an area measuring 20 square centimeters or smaller. |
63 | $90 | $200 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
55 | $67 | $150 |
| Wound tissue removal, 20 sq cm or less This procedure involves the removal of tissue from a wound area measuring 20 square centimeters or less. |
34 | $22 | $145 |
| Skin substitute graft application, 25 sq cm or less Application of a skin substitute graft to a wound on the trunk, arms, or legs covering 25 square centimeters or less. |
31 | $115 | $257 |
| Initial nursing facility care, moderate complexity Initial care provided to a patient in a nursing facility with moderate medical decision making, taking at least 35 minutes. |
19 | $96 | $250 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
13 | $121 | $313 |
| Skin graft site preparation, face or scalp, 100 sq cm or less Preparation of the skin area on the face, scalp, or other specified body parts to receive a skin graft in infants and children. The area prepared is 100 square centimeters or 1% of the body surface area, whichever is less. |
12 | $286 | $769 |
Industry Payment Transparency
Open Payments through 2024 ↗Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
Payments by company (2024)
Associated products mentioned in payments ›
The majority of payments (69%) are consulting fees, which typically reflect recognized clinical expertise sought by manufacturers. Total industry engagement is in the top 1% for family medicine in TX.
Geographic Context
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This measures how much public data is available about a provider — not how good they are. How we calculate this →
Summary
Dr. Rafols is a clinical cardiology specialist, with above-average Medicare volume (top 23% in TX), with consulting-driven industry engagement in the top 1% of TX peers, with 17 years of NPI registration.
This summary is auto-generated from federal data. It describes data availability and patterns — not clinical quality. Read our methodology →
Frequently Asked Questions
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All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. The Transparency Score measures data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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