Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Virginia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Virginia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Gordon Byrnes (NPI 1295709699)

Field	Value
Entity Type	Individual
Organization	Gordon Byrnes
Address	6354 Walker Ln Ste 100
City	Alexandria
State	VA
ZIP	22310
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	February 14, 2006

Payer Source	Total Paid
Medicare	$4.9M
Medicaid	$0

Key Findings

GORDON BYRNES has reported $4.9M in lifetime Medicare revenue and no Medicaid billing on file, making the practice effectively single‑payer Medicare in scale; the provider’s NPI was enumerated 2006-02-14 (~20 years ago), indicating an established clinical presence. This payer concentration means Medicare reimbursement trends and drug pricing/reimbursement shifts will disproportionately affect the provider’s topline.

Revenue is highly concentrated in a small set of intravitreal drug codes: J0178 ($2M, 41.4%), J2777 ($579.4K, 11.8%), and J2778 ($448.4K, 9.1%); the precomputed top‑3 codes account for 62.4% of this provider’s total Medicare revenue. That concentration highlights dependency on anti‑VEGF and related retinal injections as the core revenue drivers.

The code mix and dollars billed point to a retina‑focused, injection‑centric practice model: high volumes for injection codes such as J0178, J2777, J2778, and notable billing for J2781 (pegcetacoplan) and intravitreal implant J7312. Frequent use of advanced retina therapeutics alongside diagnostic imaging suggests the practice prioritizes medical retina care (wet AMD, other macular diseases) and in‑office biologic/drug administration rather than primarily outpatient primary eye care.

Competitive standing by code shows the provider is a major national participant on several leading retina services: J0178 ranks #192 of 3204 (94th percentile) and is described as notably above typical national volume, J2781 ranks #16 of 490 (97th percentile) and is also notably above typical national volume, while 92014 ranks #37 of 35415 (100th percentile) and is an extreme outlier. At the same time, some drug and procedural codes (e.g., J2777 at the 74th percentile and Q5128 at the 45th percentile) are in more typical ranges, indicating the provider is dominant on select lines but not uniformly across every retinal product.

Diagnostic and visit intensity is unusually high relative to peers: 92014 generated $330.9K (6.7%) and ranks as an extreme outlier (100th percentile), and 92134 generated $124.2K (2.5%) and is an extreme outlier (99th percentile). High volumes of comprehensive established visits and OCT imaging support an efficient in‑office care pathway that funnels patients into frequent follow‑up and treatment encounters.

There is a meaningful surgical component alongside office‑based therapy: 67028 (injection into the vitreous chamber as an isolated procedure) produced $250.2K (5.1%) and ranks #269 of 4255 (94th percentile), described as notably above typical national volume; lower‑volume vitrectomy codes (67036, 67042, 67041) appear at modest revenue levels. This mix indicates the practice performs both high-throughput injections and a smaller but present portfolio of retina surgeries.

Drug billing shows significant weight outside standard HCPCS drug codes: J3490 (unclassified drugs) generated $424.5K (8.7%) with a high average paid/claim of $2307 and ranks in the 87th percentile (typical, unremarkable volume), while J3590 (unclassified biologics) accounted for $80.5K (1.6%) with an average paid/claim of $2517. These unclassified drug line items represent a nontrivial share of revenue and suggest billing for high‑cost or vendor‑specific products that may require closer claims review or contracting attention.

The provider’s reliance on a narrow set of high‑value injectable therapeutics and on Medicare as the primary payer creates operational and reimbursement risk: with 62.4% of Medicare revenue coming from the top three codes, any changes in formulary access, step therapy, or reimbursement for these agents would materially impact revenue. From a payer/provider strategy perspective, risk mitigation could include diversifying service lines, codifying high‑value visit and imaging workflows, or negotiating drug acquisition/reimbursement arrangements to stabilize margins.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,950	$690	$2M
J2777	Injection, faricimab‑svoa, 0.1 mg	19,980	$30	$579.4K
J2778	Injection, ranibizumab, 0.1 mg	2,390	$190	$448.4K
J3490	Unclassified drugs	180	$2,310	$424.5K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	2,790	$120	$334.8K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	3,340	$100	$330.9K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	2,250	$110	$250.2K
Q5128	Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg	600	$210	$127.3K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	3,650	$30	$124.2K
J3590	Unclassified biologics	30	$2,520	$80.5K

Showing 1–10 of 26

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Gordon Byrnes — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

26 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	14	80	1,400	$690	$1.1M
J2777	21	60	13,200	$30	$517.1K
J2778	3	40	560	$180	$171.5K
J3590	9	20	40	$2,290	$126K
67028	11	90	1,000	$90	$107.1K
J2781	1	20	560	$120	$86.6K
Q5128	2	10	190	$220	$70.7K
J7312	9	20	240	$160	$42.5K
67042	18	20	20	$1,130	$33.8K
92014	6	870	170	$80	$32.8K

Showing 1–10 of 26

Related Providers

Other providers that share a Tax Identification Number (TIN) with Gordon Byrnes, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Retina Group Of Washington, PLLC	MD	Ophthalmology Physician	$0	$19.5M
Virginia Oncology Associates	VA	Hematology & Oncology Physician	$0	$6.2M
Rohit Lakhanpal	MD	Retina Specialist (Ophthalmology) Physician	$6.1M	$0
Daniel Berinstein	MD	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Alexander Melamud	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Michael Lai	MD	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Jordana Fein	VA	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Eric Weichel	MD	Ophthalmology Physician	$4.1M	$0
Gayatri Reilly	MD	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Sundeep Kasi	VA	Retina Specialist (Ophthalmology) Physician	$4.1M	$0

Nearby Providers

Other providers in the same ZIP code as Gordon Byrnes, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reshma Katira	VA	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Franconia-springfield Surgery Center, LLC	VA	Ambulatory Surgical Clinic/Center	$1.6M	$275.4K
Simon Fishman	VA	Specialist	$624K	$0
Michael Abidin	VA	Otolaryngology/Facial Plastic Surgery Physician	$439.2K	$0
Thomas Martinelli	VA	Orthopaedic Surgery Physician	$296.7K	$0
Peter Thomas	VA	Surgery of the Hand (Surgery) Physician	$157.7K	$0
Daniel Weingold	VA	Orthopaedic Surgery Physician	$154.1K	$0
Yvette Appiah	VA	Dermatology Physician	$136.2K	$0
Iyad Saidi	VA	Otolaryngic Allergy Physician	$124.6K	$0
Angelo Pace	VA	Foot Surgery Podiatrist	$118.9K	$0

Gordon Byrnes — Billing Profile & Reimbursement Data

Sign up for Gordon Byrnes — Billing Profile & Reimbursement Data policy alerts

Gordon Byrnes — Billing Profile & Reimbursement Data

Sign up for Gordon Byrnes — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References