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NPI 1871754846 · Albany, NY · Retina Specialist (Ophthalmology) Physician
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David Rabady is a retina specialist (ophthalmology) physician provider located in Albany, New York. This profile covers 19 Medicare and 9 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 | David Rabady |
| Address | 3 Atrium Dr |
| City | Albany |
| State | NY |
| ZIP | 12205 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | June 22, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.8M |
| Medicaid | $1.1M |
This provider operates as a high-volume retina practice focused on intravitreal drug administration and retinal diagnostics: the Medicare top CPT/HCPCS entries are J2777, J0178 and 67028 and the top 3 Medicare codes by revenue account for 86.1% of this provider's total Medicare revenue. The code mix—dominant intravitreal injections plus retinal imaging and comprehensive ophthalmologic exams—is consistent with an office-based retina specialist delivering frequent anti-VEGF and novel biologic therapies alongside diagnostic follow-up.
Medicare revenue is concentrated in a handful of injection codes: total Medicare revenue is $3.8M and J2777 alone accounts for $2.3M (60.6% of Medicare revenue) with J0178 contributing $797.5K (20.9%) and 67028 contributing $172.2K (4.5%). Because the top 3 Medicare codes together account for 86.1% of Medicare revenue, the practice’s financial profile is highly dependent on intravitreal drug administration and related procedures.
On Medicare the provider is a statistical outlier for several high-impact codes: J2777 ranks #32 of 2039 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code), 92235 ranks #32 of 2192 providers nationally (99th percentile; extreme outlier) and 92014 ranks #539 of 35415 providers nationally (98th percentile; extreme outlier). These ranks indicate nationally unusual volume in both specific drug administration (faricimab) and in retinal angiography and established comprehensive exams, suggesting market leadership on certain procedures at a national scale.
The payer mix is Medicare-dominant in scale: lifetime Medicare revenue is $3.8M versus lifetime Medicaid revenue of $1.1M, so Medicare contributes the majority of billed dollars while Medicaid is a meaningful but smaller revenue stream. On Medicaid, the top 3 codes by revenue account for 85.4% of the provider’s Medicaid revenue, indicating a similarly concentrated revenue profile across payers.
Within the New York Medicaid market the provider is a leading in-state filer for key injection agents: J2778 (ranibizumab) is $335.1K and ranks #1 of 11 providers in-state (100th percentile; notably above typical state volume for this code), and J2777 (faricimab) is $281.6K and ranks #1 of 15 providers in-state (100th percentile; notably above typical state volume). Aflibercept (J0178) also appears as a major Medicaid contributor at $315.9K but ranks #17 of 101 providers in-state (84th percentile; typical, unremarkable volume), indicating very strong state-level positioning for ranibizumab and faricimab specifically.
Ancillary diagnostic and follow-up services are also prominent and above typical volumes: Medicare shows 92134 at $51K (95th percentile national rank) and 92250 at $13.2K (96th percentile), while Medicaid shows 92134 at $12.2K (79th percentile in-state) and 92235 at $35.6K (92nd percentile in-state). These imaging and photography volumes support the clinical workflow of a retina practice that combines frequent injections with ongoing retinal imaging and documentation.
The provider has an established tenure in the market: the NPI was enumerated on 2008-06-22 (~18 years ago), consistent with time to build high procedural volumes and referral relationships reflected in the billing patterns. The longevity combined with concentrated, high-volume injection and imaging activity suggests a stable specialty practice focused on retina therapeutics.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 79,740 | $30 | $2.3M |
| J0178 | Injection, aflibercept, 1 mg | 1,180 | $680 | $797.5K |
| 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. | 2,050 | $80 | $172.2K |
| 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… | 1,570 | $90 | $136.9K |
| 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… | 870 | $100 | $82.7K |
| J3490 | Unclassified drugs | 40 | $1,690 | $74.5K |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | 510 | $120 | $61.2K |
| 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. | 1,700 | $30 | $51K |
| J7312 | Injection, dexamethasone, intravitreal implant, 0.1 mg | 200 | $160 | $30.9K |
| 67036 | The provider removes vitreous fluid from the eye to access the posterior segment of the eye and introduce surgical instruments through incisions in the pars plana. | 40 | $680 | $29.8K |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 72 | 230 | 560 | $690 | $693K |
| J2777 | 2 | 120 | 7,740 | $30 | $364.9K |
| J2781 | 19 | 40 | 520 | $120 | $75.1K |
| 67028 | 18 | 300 | 400 | $100 | $65.9K |
| J3490 | 71 | 120 | 60 | $470 | $50.8K |
| J7312 | 14 | 20 | 270 | $160 | $48K |
| 67210 | 20 | 40 | 40 | $430 | $46.9K |
| 92014 | 47 | 2,220 | 160 | $100 | $29.3K |
| 67036 | 7 | 50 | 20 | $940 | $23.5K |
| 99214 | 14,225 | 30,450 | 90 | $100 | $19K |
Showing 1–10 of 19
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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J2778 | Injection, ranibizumab, 0.1 mg | 1,280 | $260 | $335.1K |
| J0178 | Injection, aflibercept, 1 mg | 930 | $340 | $315.9K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 750 | $370 | $281.6K |
| 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. | 3,300 | $20 | $75.9K |
| 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… | 1,780 | $20 | $35.6K |
| 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… | 1,400 | $20 | $29.3K |
| 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. | 1,750 | $10 | $12.2K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 680 | $10 | $6.8K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 40 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 17 | 100 | 280 | $650 | $369.9K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 1 | 20 | 120 | $720 | $173.2K |
| J2778 | Injection, ranibizumab, 0.1 mg | 1 | 10 | 110 | $500 | $160.1K |
| 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… | 615 | 2,440 | 330 | $70 | $92.6K |
| 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. | 19 | 260 | 420 | $70 | $65.6K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 566 | 1,490 | 340 | $40 | $48.7K |
| 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… | 9 | 100 | 150 | $60 | $32.9K |
| 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. | 153 | 730 | 370 | $20 | $30K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 1,589 | 2,000 | 210 | $1 | $90 |
Other providers in the same ZIP code as David Rabady, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Consumer Directed Choices, Inc. | NY | Attendant Care Provider | $0 | $238.7M |
| Maxim Of New York, LLC | NY | Home Health Agency | $0 | $92.6M |
| Attentive Care Of Albany, Inc | NY | Home Health Agency | $0 | $36.7M |
| Robert Feldman | NY | Ophthalmology Physician | $1.8M | $165.9K |
| Everett Road Asc, LLC | NY | Ambulatory Surgical Clinic/Center | $1.7M | $240.2K |
| Martin Ferrillo | NY | Interventional Pain Medicine Physician | $425.5K | $55.3K |
| Executive Woods Ambulatory Surgery Center LLC | NY | Ambulatory Surgical Clinic/Center | $310.9K | $0 |
| Daniel Single | NY | Orthopaedic Surgery Physician | $247.5K | $0 |
| Alfonso Prieto | NY | Clinical Cardiac Electrophysiology Physician | $207.6K | $10.7K |
| Leonard Goldstock | NY | Orthopaedic Surgery Physician | $213K | $1.6K |
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