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NPI 1790750834 · Des Plaines, IL · Retina Specialist (Ophthalmology) Physician
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George Wyhinny is a retina specialist (ophthalmology) physician provider located in Des Plaines, Illinois. This profile covers 18 Medicare and 6 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | George Wyhinny |
| Address | 8901 Golf Rd |
| City | Des Plaines |
| State | IL |
| ZIP | 60016 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | February 22, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.9M |
| Medicaid | $33.9K |
Practice profile and service mix indicate a retina-focused ambulatory ophthalmology operation: the top Medicare and Medicaid procedures are intravitreal injections and retinal imaging/examination codes (J0178, J2777, 67028, 92134, 92014), consistent with ongoing medical retina care rather than predominantly surgical retinal procedures. The dominance of anti-VEGF and newer intravitreal agents as primary revenue drivers points to a clinic model built around frequent, procedure-based visits and diagnostic imaging.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes account for 80.0% of this provider's total Medicare revenue, driven primarily by J0178 (54.3% of Medicare revenue), J2777 (16.8%), and 92014 (9.0%). That level of concentration indicates most Medicare dollars are generated by a small set of recurring therapeutic and evaluation codes.
Medicaid revenue is even more concentrated: the precomputed top three Medicaid codes account for 91.4% of this provider's total Medicaid revenue, led by 67028 (60.9%), 92014 (19.9%), and 92134 (10.7%). Medicaid billing for this provider is therefore dominated by intravitreal injections and comprehensive exams with a small number of codes producing nearly all Medicaid receipts.
The payer mix is effectively single-payer dominated: reported Total Medicare revenue is $2.9M versus Total Medicaid revenue of $33.9K, so Medicare is the overwhelmingly primary payer by scale for this provider. Medicaid activity is present but represents a tiny fraction of overall reported public-payer revenue, suggesting operational and revenue sensitivity to Medicare policy and utilization trends.
Competitive standing on Medicare is mixed: 92014 is an extreme outlier at the national level (ranks #105 of 35415, 100th percentile), and 92134 is also an extreme outlier (ranks #542 of 26868, 98th percentile), indicating exceptionally high volumes of established-patient comprehensive exams and retinal imaging relative to peers. By contrast, the highest-revenue injection J0178 ranks at the 87th percentile (#404 of 3204), which is high but characterized in the file as a typical, unremarkable national volume for that code.
Competitive standing on Medicaid is modest: the leading Medicaid injection 67028 ranks #76 of 120 in-state (37th percentile) and 92014 ranks #573 of 1234 in-state (54th percentile), indicating the provider is a typical or below-leading performer on Medicaid for its primary procedures. In short, the provider is a national outlier on certain Medicare office and imaging codes but not a statewide leader on comparable Medicaid measures.
Tenure and practice stability are notable: the NPI was enumerated 2006-02-22 (~20 years ago), indicating a long-established practice that aligns with high volumes of established-patient services like 92014. Long tenure helps explain sustained Medicare volume and a built-up panel of repeat, treatment-intensive retina patients.
Billing profile shows revenue sensitivity to drug and procedure utilization: large Medicare shares come from high-cost intravitreal agents (J0178 and J2777) and a relatively small miscellaneous drug bucket (J3490) contributes $65.4K with a high avg paid/claim ($1768) but a low ranking, indicating some non-standard or high-cost claims exist alongside the high-volume core therapies. Because the practice derives most revenue from a few medication and procedure codes, changes in drug reimbursement, utilization patterns, or clinical guidelines could materially affect revenue at both payer levels.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 2,280 | $680 | $1.6M |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 16,620 | $30 | $482K |
| 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… | 2,630 | $100 | $257.5K |
| 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. | 2,080 | $100 | $197.3K |
| 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. | 2,720 | $30 | $86.9K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 600 | $120 | $72K |
| J3490 | Unclassified drugs | 40 | $1,770 | $65.4K |
| J9035 | Injection, bevacizumab, 10 mg | 650 | $50 | $34.6K |
| 92202 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 2,270 | $10 | $27.2K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 240 | $110 | $26.3K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 18 | 140 | 700 | $690 | $688.4K |
| J2777 | 31 | 90 | 9,180 | $30 | $451K |
| J2781 | 7 | 10 | 600 | $120 | $86.8K |
| 67028 | 15 | 190 | 400 | $90 | $64.4K |
| 92014 | 10 | 1,420 | 130 | $80 | $24.7K |
| J9035 | 16 | 130 | 140 | $60 | $24.6K |
| 67210 | 16 | 20 | 30 | $410 | $22K |
| J3490 | 94 | 140 | 50 | $210 | $19.4K |
| 92012 | 459 | 670 | 100 | $60 | $12.4K |
| 92134 | 26 | 1,080 | 80 | $30 | $9K |
Showing 1–10 of 18
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 300 | $70 | $20.4K |
| 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… | 550 | $10 | $6.6K |
| 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. | 510 | $10 | $3.6K |
| J9035 | Injection, bevacizumab, 10 mg | 70 | $30 | $1.8K |
| 92226 | N/A | 90 | $10 | $650 |
| 92202 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 210 | $1 | $430 |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 76 | 120 | 540 | $160 | $166.3K |
| 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… | 573 | 1,230 | 450 | $40 | $54.1K |
| J9035 | Injection, bevacizumab, 10 mg | 61 | 80 | 290 | $60 | $43.4K |
| 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. | 124 | 250 | 510 | $20 | $20.1K |
| 92226 | N/A | 36 | 50 | 430 | $20 | $19.5K |
| 92202 | The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece… | 22 | 50 | 130 | $10 | $2.4K |
Other providers in the same ZIP code as George Wyhinny, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| City Of Desplaines | IL | Land Ambulance | $784.7K | $13.1M |
| Access Community Health Network | IL | Federally Qualified Health Center (FQHC) | $0 | $11.9M |
| Med Rush Clinical Lab Inc | IL | Clinical Medical Laboratory | $2.4M | $9.3M |
| Presence Home Care | IL | Home Health Agency | $0 | $7.3M |
| Michael Blair | IL | Retina Specialist (Ophthalmology) Physician | $3M | $2.6M |
| Alan Hirsch | IL | Neurology Physician | $50.8K | $3.8M |
| Srikanth Ravindran | IL | Family Medicine Physician | $198.8K | $3.4M |
| North Maine Fire Protection District | IL | Land Ambulance | $163.2K | $3.3M |
| John Galasso | IL | Retina Specialist (Ophthalmology) Physician | $1.6M | $1.2M |
| Daniel Alter | IL | Retina Specialist (Ophthalmology) Physician | $2.7M | $9K |
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