Ralph Rahme, MD
Neurological Surgery · Falls Church, VANPI 1194046201
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (54.8%), travel and lodging and education — rather than concentrated in one kind of arrangement. 14 manufacturers reported payments, led by Stryker at 41.4% of the total. Reporting peaked in 2019 at $2,840 and has fallen 64.6% since, to $1,005 in 2025.
Across 55 payments — averaging $122.73 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$3K
- Penumbra, Inc.$2K
- VB Spine LLC$560
- Phenox Inc.$175
- Zap Surgical Systems, Inc.$164
- Johnson & Johnson$163
- plus $743 from 8 others
What the payments were for
- Travel & lodging$3,04145%
- Food & beverage$3,70055%
- Education$90%
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 |
|---|---|---|
| Stryker | 21 | $2,797 |
| Penumbra, Inc. | 9 | $2,148 |
| VB Spine LLC | 1 | $560 |
| Phenox Inc. | 1 | $175 |
| Zap Surgical Systems, Inc. | 2 | $164 |
| Johnson & Johnson | 2 | $163 |
| AstraZeneca | 5 | $161 |
| Microvention, Inc. | 1 | $143 |
| DJO, LLC | 4 | $135 |
| Integra Lifesciences Corporation | 3 | $115 |
| Meticuly Inc. | 1 | $62 |
| Ossdsign USA Incorporated | 2 | $55 |
| Zimmer Biomet | 2 | $51 |
| Portola Pharmaceuticals, LLC | 1 | $21 |
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.
- Penumbra System$4,152
- TREVO$1,197
- YUKON OCT SPINAL SYSTEM$560
- EVOLVE$458
- TRITANIUM$240
- Avenir Coil$175
- CASCADIA INTERBODY SYSTEM$170
- WEB$143
- LVIS$143
- Headway Duo Microcatheter$143
- EVEREST SPINAL SYSTEM$122
- EMBOTRAP II Revascularization Device$117
- ANDEXXA$109
- Penumbra Jet 7$108
How this compares
$6,750 in reported general payments places this provider in the 65th percentile of 156 neurological surgery 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.
Other neurological surgery in Falls Church
- Sidhartha ChandelaFalls Church$22K
- Justin SmithCharlottesville$2.3M
- David VincentVirginia Beach$959K
- Mudit SharmaManassas$714K
- Ryan KelloggCharlottesville$245K
- Andrew FanousAlexandria$185K
- Bernardo OrdonezChesapeake$178K
- Parker BabingtonNorfolk$164K
- Devon LefeverChesapeake$148K
- James BrennanNorfolk$130K
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.