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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Providers
  3. Harvey Paley
⚕️
MDIndividual

Harvey Paley, M.D.

NPI: 1225185465
Beverly Hills, CA
10 years of data
Otolaryngology
$29.8M
Total Payments
156
Beneficiaries
476.7K
Services
4.43x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$29.8M
Specialty median$80.5K

📋 Key Findings

1Billed $29.8M over 10 years
24.43x markup ratio (above median)
399th percentile in Otolaryngology by payments
4191 services/day — unusually high
5Payments surged 110% in 2016
67 procedures with >3x markup

This provider averages 191 services per working day

Based on 476.7K total services over 10 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $29.8M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.

Averaging 191 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 1057% from 2014 to 2023.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 110% in 2016

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$213.79$67.713.16x$146.08$768.3K11.3K12
2015$205.30$64.193.20x$141.11$767.6K12.0K13
2016$204.71$58.913.47x$145.80$1.6M27.3K19
2017$224.39$65.153.44x$159.24$1.4M21.8K16
2018$225.38$63.233.56x$162.15$2.2M34.0K22
2019$270.41$61.234.42x$209.18$2.7M44.0K18
2020$290.98$61.754.71x$229.23$2.3M37.2K15
2021$300.21$63.944.70x$236.27$3.8M59.1K13
2022$297.86$61.024.88x$236.84$5.4M88.7K14
2023$296.68$62.904.72x$233.78$8.9M141.3K14

Top Procedures (18)

31525Diagnostic exam of voice box using an endoscope⚠ 3.6x markup
$13.0M
98.7K services$131.50/svc3.62x markup
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes
$5.1M
48.0K services$106.93/svc2.32x markup
31231Diagnostic exam of nasal passages using an endoscope⚠ 12.0x markup
$3.9M
122.7K services$31.59/svc11.98x markup
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes
$3.8M
48.1K services$79.56/svc2.38x markup
69210Removal of impacted ear wax⚠ 7.0x markup
$1.7M
122.8K services$13.65/svc7.03x markup
99304Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes
$1.2M
16.4K services$72.06/svc2.49x markup
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes
$764.8K
13.2K services$57.77/svc2.50x markup
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes
$158.4K
1.2K services$135.61/svc1.91x markup
99307Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes
$61.7K
1.8K services$33.91/svc2.64x markup
99214Established patient office or other outpatient, visit typically 25 minutes
$56.3K
651 services$86.44/svc2.11x markup
92504Exam of ear using a microscope⚠ 6.2x markup
$22.9K
2.5K services$9.30/svc6.19x markup
99204New patient office or other outpatient visit, typically 45 minutes
$18.2K
148 services$122.88/svc2.75x markup
31535Biopsy of voice box using an endoscope
$14.3K
90 services$158.80/svc2.46x markup
99310Subsequent nursing facility visit, typically 35 minutes per day
$10.1K
106 services$94.85/svc2.70x markup
99205New patient office or other outpatient visit, typically 60 minutes
$4.2K
30 services$141.10/svc1.42x markup
99406Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes⚠ 7.9x markup
$3.2K
250 services$12.66/svc7.90x markup
G0436Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes⚠ 7.7x markup
$594.29
46 services$12.92/svc7.74x markup
30300Removal of foreign body in nose⚠ 10.0x markup
$559.98
16 services$35.00/svc10.00x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
31525Diagnostic exam of voice box using an endoscope98.7K$13.0M$131.503.62x
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes48.0K$5.1M$106.932.32x
31231Diagnostic exam of nasal passages using an endoscope122.7K$3.9M$31.5911.98x
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes48.1K$3.8M$79.562.38x
69210Removal of impacted ear wax122.8K$1.7M$13.657.03x
99304Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes16.4K$1.2M$72.062.49x
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes13.2K$764.8K$57.772.50x
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes1.2K$158.4K$135.611.91x
99307Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes1.8K$61.7K$33.912.64x
99214Established patient office or other outpatient, visit typically 25 minutes651$56.3K$86.442.11x
92504Exam of ear using a microscope2.5K$22.9K$9.306.19x
99204New patient office or other outpatient visit, typically 45 minutes148$18.2K$122.882.75x
31535Biopsy of voice box using an endoscope90$14.3K$158.802.46x
99310Subsequent nursing facility visit, typically 35 minutes per day106$10.1K$94.852.70x
99205New patient office or other outpatient visit, typically 60 minutes30$4.2K$141.101.42x
99406Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes250$3.2K$12.667.90x
G0436Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes46$594.29$12.927.74x
30300Removal of foreign body in nose16$559.98$35.0010.00x

Markup Analysis

Charge-to-Payment Ratio

4.43x

This provider submits charges 4.43 times higher than what Medicare actually pays.

What This Means

A markup ratio of 4.43x means for every $100 Medicare pays, this provider initially charges $443. This is higher than the national average.

Location

Beverly Hills, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

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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