This provider's $3.3M 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 | $421.84 | $127.82 | 3.30x | $294.02 | $323.0K | 4.5K | 2.8K |
| 2015 | $547.07 | $118.98 | 4.60x | $428.09 | $328.8K | 4.6K | 2.8K |
| 2016 | $394.67 | $120.26 | 3.28x | $274.41 | $359.1K | 5.3K | 3.3K |
| 2017 | $295.71 | $84.68 | 3.49x | $211.03 | $300.7K | 5.1K | 3.3K |
| 2018 | $434.15 | $113.06 | 3.84x | $321.09 | $345.1K | 5.3K | 3.5K |
| 2019 | $441.40 | $109.99 | 4.01x | $331.41 | $389.0K | 5.7K | 3.7K |
| 2020 | $297.46 | $97.02 | 3.07x | $200.44 | $296.6K | 4.6K | 3.0K |
| 2021 | $321.60 | $112.49 | 2.86x | $209.11 | $325.6K | 4.6K | 2.8K |
| 2022 | $233.40 | $79.23 | 2.95x | $154.17 | $327.3K | 4.8K | 3.1K |
| 2023 | $516.88 | $129.67 | 3.99x | $387.21 | $342.5K | 4.7K | 3.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 19.7K | $1.1M | $56.60 | 1.95x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 6.5K | $568.7K | $87.78 | 2.94x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.4K | $515.8K | $151.43 | 2.56x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 5.5K | $421.0K | $76.65 | 2.62x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.8K | $164.3K | $34.51 | 2.00x |
| 92504 | Diagnostic examination of ear and nose | 3.7K | $78.2K | $20.95 | 3.34x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 625 | $67.3K | $107.71 | 2.61x |
| 30903 | Complex control of nose bleed | 323 | $54.1K | $167.46 | 2.72x |
| 69210 | Removal of impact ear wax, one ear | 1.3K | $44.9K | $33.66 | 6.79x |
| 69222 | Removal of skin debris and drainage of mastoid cavity | 267 | $44.5K | $166.78 | 2.81x |
| 30520 | Reshaping of nasal cartilage | 80 | $34.1K | $425.76 | 3.20x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.1K | $31.8K | $28.09 | 3.72x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 165 | $25.4K | $153.99 | 2.86x |
| 30140 | Removal of nasal air passage | 96 | $24.7K | $257.21 | 6.38x |
| 31255 | Removal of nasal sinus using an endoscope | 69 | $24.2K | $350.77 | 5.66x |
| 31535 | Biopsy of voice box using an endoscope | 168 | $23.5K | $139.59 | 3.82x |
| 31536 | Biopsy of voice box using an endoscope with operating microscope or telescope | 121 | $20.2K | $166.57 | 3.55x |
| 43197 | Diagnostic examination of esophagus using an endoscope | 79 | $11.4K | $144.48 | 3.81x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 196 | $11.2K | $57.24 | 1.93x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 46 | $11.0K | $238.90 | 3.84x |
This provider submits charges 2.6 times higher than what Medicare actually pays.
A markup ratio of 2.6x means for every $100 Medicare pays, this provider initially charges $260. 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