This provider's $6.0M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 73% from 2014 to 2023.
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 | $183.86 | $66.74 | 2.75x | $117.12 | $439.3K | 6.0K | 4.2K |
| 2015 | $206.12 | $74.33 | 2.77x | $131.79 | $485.3K | 7.0K | 5.0K |
| 2016 | $199.29 | $66.18 | 3.01x | $133.11 | $416.7K | 6.4K | 4.5K |
| 2017 | $177.62 | $58.99 | 3.01x | $118.63 | $444.9K | 7.1K | 4.8K |
| 2018 | $188.76 | $61.33 | 3.08x | $127.43 | $547.4K | 8.1K | 5.4K |
| 2019 | $206.03 | $69.14 | 2.98x | $136.89 | $685.7K | 9.5K | 6.2K |
| 2020 | $249.85 | $82.80 | 3.02x | $167.05 | $614.7K | 8.8K | 5.8K |
| 2021 | $241.32 | $102.01 | 2.37x | $139.31 | $856.3K | 10.9K | 8.0K |
| 2022 | $169.77 | $90.45 | 1.88x | $79.32 | $786.6K | 10.4K | 7.7K |
| 2023 | $127.32 | $75.78 | 1.68x | $51.54 | $759.4K | 9.8K | 7.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 33.1K | $2.0M | $59.16 | 1.91x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 11.7K | $1.9M | $161.17 | 1.79x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 7.4K | $577.3K | $78.11 | 2.40x |
| 69210 | Removal of impact ear wax, one ear | 10.6K | $346.9K | $32.59 | 2.21x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.8K | $267.1K | $95.14 | 1.79x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.0K | $187.3K | $94.82 | 2.43x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $151.9K | $121.71 | 2.04x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 3.1K | $120.7K | $38.38 | 1.90x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 330 | $55.1K | $167.04 | 3.19x |
| 69420 | Incision, aspiration, and/or inflation of eardrum | 319 | $47.9K | $150.15 | 3.25x |
| 95992 | Repositioning maneuvers for treatment of vertigo, per day | 1.1K | $37.3K | $34.89 | 1.80x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 142 | $36.0K | $253.24 | 1.62x |
| 30901 | Simple control of nose bleed | 327 | $34.6K | $105.88 | 2.77x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.2K | $33.5K | $28.99 | 3.39x |
| 92546 | Assessment and recording of abnormal eye movement with patient in a rotating chair | 330 | $33.4K | $101.22 | 1.52x |
| 92584 | Testing of nerve from ear to brain (cochlear) | 343 | $32.7K | $95.44 | 1.70x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 351 | $31.8K | $90.58 | 1.61x |
| 92519 | Vemp testing of upper and lower branches of inner ear nerve with interpretation and report | 284 | $27.3K | $96.09 | 1.82x |
| 92653 | Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report | 349 | $24.9K | $71.23 | 1.58x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 2.7K | $22.4K | $8.32 | 3.06x |
This provider submits charges 2 times higher than what Medicare actually pays.
A markup ratio of 2x means for every $100 Medicare pays, this provider initially charges $200. This is lower than the national average.
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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.
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