This provider's $7.3M 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 | $403.09 | $232.64 | 1.73x | $170.45 | $846.8K | 6.4K | 4.9K |
| 2015 | $393.33 | $225.77 | 1.74x | $167.56 | $814.8K | 6.5K | 4.9K |
| 2016 | $375.03 | $206.32 | 1.82x | $168.71 | $1.0M | 7.4K | 5.7K |
| 2017 | $399.50 | $205.32 | 1.95x | $194.18 | $684.8K | 6.1K | 4.7K |
| 2018 | $451.12 | $288.12 | 1.57x | $163.00 | $786.4K | 5.8K | 4.6K |
| 2019 | $370.87 | $215.40 | 1.72x | $155.47 | $675.7K | 5.8K | 4.6K |
| 2020 | $405.43 | $267.11 | 1.52x | $138.32 | $552.7K | 4.9K | 3.8K |
| 2021 | $418.11 | $278.15 | 1.50x | $139.96 | $620.1K | 5.4K | 4.1K |
| 2022 | $380.60 | $249.79 | 1.52x | $130.81 | $653.7K | 5.7K | 4.3K |
| 2023 | $672.27 | $242.43 | 2.77x | $429.84 | $662.2K | 6.5K | 4.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 7.3K | $1.2M | $167.12 | 1.42x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.2K | $889.4K | $87.59 | 1.44x |
| 31298 | Dilation of nasal sinus using an endoscope | 194 | $645.5K | $3.3K | 1.57x |
| 31296 | Dilation of nasal sinus using an endoscope | 316 | $604.3K | $1.9K | 1.50x |
| 31295 | Dilation of nasal sinus using an endoscope | 510 | $558.0K | $1.1K | 2.51x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 8.6K | $504.3K | $58.90 | 1.53x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.9K | $360.5K | $124.12 | 1.45x |
| 31297 | Dilation of nasal sinus using an endoscope | 309 | $315.6K | $1.0K | 2.64x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 4.5K | $308.3K | $67.97 | 2.11x |
| 69210 | Removal of impact ear wax, one ear | 9.2K | $290.7K | $31.71 | 1.64x |
| 70486 | CT scan of face | 2.3K | $252.5K | $110.99 | 1.45x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 754 | $205.4K | $272.45 | 1.38x |
| 76536 | Ultrasound of head and neck | 2.0K | $188.4K | $94.22 | 1.42x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.8K | $141.7K | $77.79 | 1.59x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.1K | $135.9K | $121.15 | 1.36x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 690 | $94.3K | $136.59 | 1.54x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 2.4K | $78.6K | $32.89 | 1.54x |
| 31238 | Control of nasal bleeding using an endoscope | 320 | $66.7K | $208.33 | 1.43x |
| 10022 | Fine needle aspiration using imaging guidance | 313 | $36.3K | $116.07 | 1.30x |
| 10005 | Fine needle aspiration of first lesion using ultrasound guidance | 319 | $35.1K | $110.17 | 1.43x |
This provider submits charges 1.64 times higher than what Medicare actually pays.
A markup ratio of 1.64x means for every $100 Medicare pays, this provider initially charges $164. 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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