This provider's $4.8M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $380.92 | $105.98 | 3.59x | $274.94 | $385.8K | 5.3K | 3.2K |
| 2015 | $334.58 | $107.02 | 3.13x | $227.56 | $446.6K | 5.7K | 3.3K |
| 2016 | $394.19 | $98.54 | 4.00x | $295.65 | $462.7K | 6.0K | 3.7K |
| 2017 | $339.62 | $107.44 | 3.16x | $232.18 | $425.1K | 5.6K | 3.4K |
| 2018 | $343.79 | $116.18 | 2.96x | $227.61 | $462.6K | 6.1K | 3.6K |
| 2019 | $342.04 | $123.29 | 2.77x | $218.75 | $515.1K | 6.2K | 3.8K |
| 2020 | $381.14 | $141.50 | 2.69x | $239.64 | $423.7K | 4.7K | 3.0K |
| 2021 | $344.54 | $134.25 | 2.57x | $210.29 | $588.4K | 6.1K | 3.7K |
| 2022 | $359.05 | $130.62 | 2.75x | $228.43 | $598.2K | 6.1K | 3.8K |
| 2023 | $289.02 | $98.03 | 2.95x | $190.99 | $460.8K | 5.3K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 14.7K | $1.0M | $70.98 | 2.32x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 5.4K | $812.0K | $150.33 | 3.33x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 5.1K | $461.1K | $90.70 | 3.48x |
| 99221 | Initial hospital inpatient care, typically 30 minutes per day | 3.0K | $280.1K | $93.13 | 2.37x |
| 69210 | Removal of impact ear wax, one ear | 6.1K | $272.7K | $44.61 | 2.76x |
| 60200 | Incision of thyroid cyst or growth | 388 | $218.8K | $563.83 | 2.24x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 2.9K | $188.6K | $65.66 | 2.58x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.1K | $170.1K | $153.12 | 2.41x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.3K | $140.7K | $109.89 | 2.39x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 910 | $112.6K | $123.71 | 2.55x |
| 31610 | Creation of permanent opening of windpipe for breathing | 104 | $100.3K | $964.10 | 1.74x |
| 92616 | Evaluation and recording of swallowing and voice box sensory function using an endoscope | 521 | $99.9K | $191.84 | 2.53x |
| 43202 | Biopsy of esophagus using an endoscope | 296 | $94.2K | $318.39 | 2.52x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 2.5K | $82.7K | $33.72 | 2.71x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 813 | $78.5K | $96.52 | 2.52x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 421 | $76.8K | $182.53 | 3.06x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 2.5K | $72.4K | $29.47 | 3.47x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 617 | $59.5K | $96.49 | 2.68x |
| 31600 | Opening of windpipe through neck for insertion of breathing tube | 295 | $56.7K | $192.18 | 5.51x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 909 | $40.3K | $44.39 | 2.33x |
This provider submits charges 2.83 times higher than what Medicare actually pays.
A markup ratio of 2.83x means for every $100 Medicare pays, this provider initially charges $283. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
Believe this data is inaccurate? Dispute this data