This provider's $3.7M 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 | $236.81 | $98.78 | 2.40x | $138.03 | $357.0K | 5.4K | 4.3K |
| 2015 | $254.10 | $103.34 | 2.46x | $150.76 | $354.8K | 5.8K | 4.5K |
| 2016 | $243.52 | $98.68 | 2.47x | $144.84 | $362.6K | 6.1K | 4.7K |
| 2017 | $232.37 | $89.10 | 2.61x | $143.27 | $377.9K | 6.4K | 4.9K |
| 2018 | $246.99 | $96.21 | 2.57x | $150.78 | $375.8K | 6.4K | 4.9K |
| 2019 | $248.44 | $100.10 | 2.48x | $148.34 | $400.7K | 6.5K | 5.0K |
| 2020 | $250.33 | $93.21 | 2.69x | $157.12 | $326.8K | 5.3K | 4.3K |
| 2021 | $256.40 | $96.08 | 2.67x | $160.32 | $365.3K | 5.7K | 4.5K |
| 2022 | $258.34 | $93.58 | 2.76x | $164.76 | $364.8K | 5.7K | 4.5K |
| 2023 | $257.58 | $97.41 | 2.64x | $160.17 | $413.2K | 6.0K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 20.0K | $1.0M | $51.04 | 1.44x |
| 69210 | Removal of impact ear wax, one ear | 16.7K | $607.8K | $36.35 | 3.66x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 7.1K | $575.5K | $80.71 | 1.86x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.6K | $424.7K | $165.88 | 1.33x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 3.1K | $300.3K | $96.55 | 3.00x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.3K | $260.4K | $79.18 | 1.42x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 852 | $106.3K | $124.73 | 1.81x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 506 | $83.4K | $164.89 | 2.61x |
| 31238 | Control of nasal bleeding using an endoscope | 361 | $76.9K | $212.91 | 5.64x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 2.6K | $76.2K | $29.36 | 2.43x |
| 69420 | Incision, aspiration, and/or inflation of eardrum | 341 | $52.7K | $154.67 | 1.66x |
| 30903 | Complex control of nose bleed | 202 | $35.1K | $173.74 | 1.93x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 762 | $30.3K | $39.71 | 3.46x |
| 69200 | Removal of foreign body from ear canal | 271 | $17.8K | $65.56 | 2.29x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 64 | $13.9K | $217.43 | 2.30x |
| 69220 | Removal of skin debris and drainage of mastoid cavity | 110 | $7.8K | $70.98 | 1.75x |
| 69424 | Removal of implanted eardrum tube under anesthesia | 42 | $4.4K | $105.75 | 2.23x |
| 92567 | Eardrum testing using ear probe | 279 | $3.4K | $12.28 | 2.95x |
| J1040 | Injection, methylprednisolone acetate, 80 mg | 70 | $563.66 | $8.05 | 4.97x |
| 92553 | Pure tone air and bone conduction hearing assessment | 12 | $329.28 | $27.44 | 1.28x |
This provider submits charges 2.16 times higher than what Medicare actually pays.
A markup ratio of 2.16x means for every $100 Medicare pays, this provider initially charges $216. This is higher 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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