This provider's $3.4M 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 | $144.39 | $64.44 | 2.24x | $79.95 | $334.6K | 5.9K | 4.6K |
| 2015 | $157.10 | $71.06 | 2.21x | $86.04 | $355.1K | 6.3K | 5.0K |
| 2016 | $150.51 | $64.36 | 2.34x | $86.15 | $353.3K | 6.4K | 4.9K |
| 2017 | $131.52 | $53.26 | 2.47x | $78.26 | $293.0K | 6.1K | 4.8K |
| 2018 | $114.15 | $49.52 | 2.31x | $64.63 | $340.4K | 7.2K | 5.8K |
| 2019 | $113.54 | $50.60 | 2.24x | $62.94 | $354.0K | 7.1K | 5.8K |
| 2020 | $115.38 | $51.21 | 2.25x | $64.17 | $302.0K | 6.0K | 5.0K |
| 2021 | $116.89 | $52.72 | 2.22x | $64.17 | $347.0K | 6.8K | 5.8K |
| 2022 | $111.79 | $50.23 | 2.23x | $61.56 | $342.0K | 7.1K | 6.1K |
| 2023 | $123.08 | $51.92 | 2.37x | $71.16 | $351.2K | 6.7K | 5.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 15.8K | $899.1K | $56.94 | 2.18x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.8K | $599.4K | $156.14 | 2.27x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 4.4K | $340.8K | $77.71 | 2.37x |
| 92504 | Diagnostic examination of ear and nose | 11.0K | $237.0K | $21.54 | 2.34x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.6K | $233.3K | $90.97 | 2.16x |
| 69210 | Removal of impact ear wax, one ear | 6.1K | $208.2K | $34.05 | 2.52x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 5.4K | $188.0K | $34.67 | 2.14x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.9K | $170.8K | $90.49 | 2.03x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 3.4K | $131.6K | $38.66 | 2.39x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 4.1K | $117.0K | $28.75 | 2.31x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 883 | $111.8K | $126.65 | 2.22x |
| 92567 | Eardrum testing using ear probe | 3.8K | $46.6K | $12.12 | 2.08x |
| 70486 | CT scan of face | 297 | $33.5K | $112.84 | 2.83x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 328 | $14.9K | $45.45 | 1.58x |
| 30901 | Simple control of nose bleed | 122 | $10.0K | $82.28 | 2.02x |
| 69200 | Removal of foreign body from ear canal | 116 | $8.0K | $69.18 | 2.30x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 591 | $4.8K | $8.07 | 2.98x |
| 92537 | Assessment and recording of balance system during hot and cold irrigation of both ears | 216 | $4.1K | $19.12 | 1.60x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 34 | $3.6K | $106.28 | 2.20x |
| 11100 | Biopsy of single growth of skin and/or tissue | 37 | $3.0K | $81.15 | 2.15x |
This provider submits charges 2.25 times higher than what Medicare actually pays.
A markup ratio of 2.25x means for every $100 Medicare pays, this provider initially charges $225. 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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