This provider's $8.8M 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 | $2.2K | $418.90 | 5.31x | $1.8K | $1.0M | 5.8K | 4.5K |
| 2015 | $2.1K | $434.89 | 4.89x | $1.7K | $1.1M | 6.0K | 4.7K |
| 2016 | $2.1K | $439.13 | 4.68x | $1.6K | $967.2K | 5.7K | 4.5K |
| 2017 | $1.8K | $424.15 | 4.26x | $1.4K | $993.2K | 5.4K | 4.2K |
| 2018 | $2.3K | $679.83 | 3.41x | $1.6K | $994.8K | 5.6K | 4.4K |
| 2019 | $2.1K | $681.30 | 3.01x | $1.4K | $944.3K | 5.8K | 4.5K |
| 2020 | $2.3K | $818.50 | 2.80x | $1.5K | $730.8K | 4.2K | 3.4K |
| 2021 | $2.2K | $771.71 | 2.79x | $1.4K | $803.4K | 4.9K | 3.8K |
| 2022 | $1.9K | $586.95 | 3.20x | $1.3K | $696.6K | 4.9K | 4.0K |
| 2023 | $949.52 | $249.93 | 3.80x | $699.59 | $553.7K | 4.8K | 3.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 17.0K | $3.1M | $182.41 | 3.70x |
| 31295 | Dilation of nasal sinus using an endoscope | 617 | $1.2M | $1.9K | 4.39x |
| 31296 | Dilation of nasal sinus using an endoscope | 314 | $801.7K | $2.6K | 3.38x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 8.9K | $796.8K | $89.44 | 3.95x |
| 31298 | Dilation of nasal sinus using an endoscope | 125 | $617.1K | $4.9K | 2.02x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 5.5K | $589.3K | $107.09 | 3.72x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.2K | $386.7K | $309.83 | 4.59x |
| 69210 | Removal of impact ear wax, one ear | 10.1K | $281.9K | $27.83 | 6.23x |
| 31297 | Dilation of nasal sinus using an endoscope | 184 | $270.7K | $1.5K | 5.63x |
| 31238 | Control of nasal bleeding using an endoscope | 686 | $175.1K | $255.31 | 4.54x |
| 76536 | Ultrasound of head and neck | 1.7K | $139.3K | $81.67 | 5.19x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 3.3K | $123.9K | $37.54 | 3.84x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $87.5K | $75.52 | 3.18x |
| 31276 | Exploration of nasal sinus using an endoscope | 83 | $50.1K | $603.74 | 4.17x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 120 | $26.4K | $219.86 | 6.63x |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 184 | $23.5K | $127.68 | 4.15x |
| 31255 | Removal of nasal sinus using an endoscope | 78 | $22.3K | $286.42 | 7.37x |
| 10022 | Fine needle aspiration using imaging guidance | 159 | $20.6K | $129.25 | 3.60x |
| 92504 | Diagnostic examination of ear and nose | 765 | $20.1K | $26.22 | 4.03x |
| 30520 | Reshaping of nasal cartilage | 43 | $18.0K | $419.22 | 5.11x |
This provider submits charges 3.93 times higher than what Medicare actually pays.
A markup ratio of 3.93x means for every $100 Medicare pays, this provider initially charges $393. 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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