Medicare Enrolled

Dr. Rafael Rafols, M.D.

Family Medicine · Edinburg, TX
Practice pattern: Clinical Cardiology— Primarily office-based clinical cardiology
Consulting-driven
5509 DOCTORS DR, Edinburg, TX 78539
9563625525
In practice since 2008 (17 years)
NPI: 1609028612 verify on NPPES ↗
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating. This page presents federal public records about Dr. Rafols from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
Are you Dr. Rafols? Request a correction or review of any data shown here. Provider portal →

What this data tells you about Dr. Rafols

Dr. Rafael Rafols is a family medicine in Edinburg, TX, with 17 years in practice. 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.

✓ 17 years in practice▲ Top 23% volume in TX$ $33,521 industry payments

Medicare Practice Summary

Medicare Utilization ↗
1,228
Medicare services
Top 23% in TX for family medicine
549
Unique beneficiaries
$80
Avg. Medicare payment
Medicare patients only (65+ / disabled) · Not a quality rating · How to read this →
~72 Medicare services per year of practice

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.

ProcedureVolumeAvg. paidAvg. submitted
Nursing facility visit, low complexity249$56$130
Initial hospital admission, moderate complexity230$96$260
Hospital follow-up visit, moderate complexity222$60$185
Hospital follow-up visit, high complexity164$91$195
Office visit, established patient (30-39 min)136$95$177
Removal of skin and tissue, 20.0 sq cm or less63$90$200
Office visit, established patient (20-29 min)55$67$150
Removal of tissue from wound, 20.0 sq cm or less34$22$145
Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less31$115$257
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes19$96$250
New patient office visit (45-59 min)13$121$313
Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less12$286$769
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.

Industry Payment Transparency

Open Payments through 2024 ↗
$33,521
Total received (2018-2024)
Avg $4,789/year across 7 years
Top 1% in TX for family medicine
23
Companies
335
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →

Payment profile

Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.

Consulting
Expert advisory fees, typically reflecting recognized clinical expertise
$23,224 (69.3%)
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$10,297 (30.7%)

Payment trend by year

Annual totals from pharmaceutical and medical device companies.

2024
$8,052
2023
$8,718
2022
$10,605
2021
$1,051
2020
$1,130
2019
$2,629
2018
$1,335

Payments by company (2024)

Consulting
Speaking
Meals & Travel
Research
ConvaTec Inc.
$23,349
Misonix Inc
$2,585
Smith+Nephew, Inc.
$1,617
Bioventus LLC
$1,463
Osiris Therapeutics Inc.
$1,256
TRIAD LIFE SCIENCES INC.
$750
MEDELA LLC
$553
ABBVIE INC.
$284
MEDLINE INDUSTRIES LP
$253
KCI USA, Inc.
$208
Next Science LLC
$185
Kerecis Limited
$163
Paratek Pharmaceuticals, Inc.
$125
Organogenesis Inc.
$112
PolarityTE, Inc.
$96
Abbott Laboratories
$96
Cardiovascular Systems Inc.
$94
Amnio Technology, LLC
$86
Integra LifeSciences Corporation
$78
TEI Biosciences Inc
$77
Pulmonx Corporation
$47
Hydrofera LLC
$23
RedDress USA, Inc.
$21
Top 3 companies account for 82.2% of total payments
Associated products mentioned in payments ›
ACTIV.A.C. iOn PROGRESS · ACTIVAC · AQUACEL AG+ · AQUACEL Ag Advantage · AQUACEL FOAM · Apligraf · CHARTIS CATHETER · COLLAGENASE SANTYL · CONVATEC INC. · CYTAL · DALVANCE · DIAMONDBACK CORONARY · GRAFIX PL · GRAFIX XC · GRAFIX/GRAFIXPL/STRAVIX · GoFlo Pole Pump · Grafix PL PRIME · Grafix PRIME · HYDROFERA BLUE · INC. · INNOVAMATRIX AC · Kerecis Omega3 SurgiClose · MEDLINE INDUSTRIES · NUZYRA · Oasis · Other · Peripheral Orbital Atherectomy System · REGRANEX · SNAP · STRAVIX · SURGIMEND · Santyl · SkinTE · Stravix · SurgX · TEFLARO · TheraSkin · Theragenesis Bilayer Wound Matrix · V.A.C. DERMATAC
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →

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.

Equivalent to $2,730 per 100 Medicare services performed
Looking for a family medicine in Edinburg?
Compare family medicines in the Edinburg area by procedure volume, costs, and industry payment transparency.
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Geographic Context

Family Medicines within 10 mi
257
Per 100K population
29.2
County median income
$52,281
Nearest hospital
SOUTH TEXAS HEALTH SYSTEM
0.0 mi

Data Sources

Provider Registry NPPESWeekly updates
Medicare Enrollment PECOSMonthly updates
Practice Data Medicare Util.Annual (CY lag)
Industry Payments Open PaymentsCY 2024
Disciplinary History— Not publicN/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), and high industry engagement (consulting-driven, top 1%), with 17 years of practice experience.

This summary is auto-generated from federal data. It describes data availability and patterns — not clinical quality. Read our methodology →

Frequently Asked Questions

Is Dr. Rafols experienced with nursing facility visit, low complexity?
Based on Medicare claims data, Dr. Rafols performed 249 nursing facility visit, low complexity services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Rafols receive payments from pharmaceutical companies?
Yes. Dr. Rafols received a total of $33,521 from 23 companies across 335 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Rafols's costs compare to other family medicines in Edinburg?
Dr. Rafols's average Medicare payment per service is $80. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Rafols) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
About this page

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.

Provider corrections: Provider portal · Privacy questions: Privacy Policy · Terms: Terms of Use · Methodology: Methodology

Data Disclaimer — Data sourced from the Centers for Medicare & Medicaid Services (CMS): National Plan and Provider Enumeration System (NPPES), Open Payments program, Medicare Provider Utilization and Payment Data, and Provider Enrollment & Certification data (PECOS). Published under the Freedom of Information Act (FOIA). This website is not affiliated with, endorsed by, or authorized by CMS, HHS, or the U.S. Government. Data may contain errors as reported to CMS by providers and reporting entities. Payments from industry are legal and do not indicate wrongdoing. Medicare data reflects only patients aged 65+ or those with qualifying disabilities. For corrections, contact CMS directly. This information does not constitute medical advice and should not be used as the sole basis for choosing a healthcare provider. Procedure descriptions use plain language and do not reference CPT® codes, which are copyrighted by the American Medical Association. Full methodology → · Report a data error → · Privacy policy →