Daniel Rukstalis, MD
Urology · Roanoke, VANPI 1245296375
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 96.2% of the total across 18 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 13 manufacturers, the largest accounting for just 14.4% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2024 at $341 and has fallen 97.2% since, to $10 in 2025. That places this record below the midpoint for urology clinicians in VA, where the typical reported total is $2,551.
Across 18 payments — averaging $60.74 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Virtual Incision Corporation$157
- Procept Biorobotics Corporation$151
- Koelis Inc.$125
- Teleflex LLC$125
- Agiliti Surgical, Inc.$116
- Boston Scientific$115
- plus $304 from 7 others
What the payments were for
- Food & beverage$1,05296%
- Gifts$414%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Virtual Incision Corporation | 2 | $157 |
| Procept Biorobotics Corporation | 1 | $151 |
| Koelis Inc. | 2 | $125 |
| Teleflex LLC | 1 | $125 |
| Agiliti Surgical, Inc. | 1 | $116 |
| Boston Scientific | 1 | $115 |
| Ambu Inc. | 2 | $109 |
| Neotract Inc. | 1 | $48 |
| Welch Allyn | 1 | $41 |
| EDAP Technomed Inc | 2 | $37 |
| Laborie Medical Technologies Corp. | 1 | $33 |
| Medtronic | 2 | $26 |
| Histosonics, Inc. | 1 | $10 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- AQUABEAM SYSTEM$151
- Mira!$134
- UroLift$125
- Cryocare CS$116
- GENERAL - THERAPIES$115
How this compares
$1,093 in reported general payments places this provider in the 30th percentile of 300 urology providers in Virginia.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| MyrbetriqMirabegron | 36 | $18,640 |
| Tamsulosin Hcl | 90 | $425 |
| Finasteride | 19 | $45 |
Paid to pharmacies, not to this prescriber.
Other urology in Roanoke
- Charles DanielRoanoke$94K
- David KageyRoanoke$90K
- Rodney PoffenbergerRoanoke$85K
- Robert WhisnantRoanoke$84K
- Mark SchmidtRoanoke$84K
- Yu ZhangRoanoke$34K
- Michael FabrizioVirginia Beach$1.5M
- Gregg EureVirginia Beach$1.4M
- Jessica DelongVirginia Beach$578K
- Robert GivenVirginia Beach$157K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.