This provider's $4.3M 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 | $196.57 | $59.33 | 3.31x | $137.24 | $374.2K | 5.6K | 3.8K |
| 2015 | $194.22 | $59.09 | 3.29x | $135.13 | $388.7K | 5.9K | 3.8K |
| 2016 | $206.10 | $63.97 | 3.22x | $142.13 | $381.3K | 5.8K | 3.8K |
| 2017 | $210.99 | $67.24 | 3.14x | $143.75 | $444.5K | 6.3K | 4.2K |
| 2018 | $220.38 | $70.45 | 3.13x | $149.93 | $441.0K | 5.9K | 3.6K |
| 2019 | $240.82 | $68.52 | 3.51x | $172.30 | $484.6K | 6.6K | 3.8K |
| 2020 | $238.90 | $76.59 | 3.12x | $162.31 | $361.4K | 5.4K | 2.9K |
| 2021 | $239.61 | $87.68 | 2.73x | $151.93 | $507.7K | 6.8K | 3.6K |
| 2022 | $220.18 | $75.40 | 2.92x | $144.78 | $467.1K | 6.6K | 3.6K |
| 2023 | $260.71 | $86.97 | 3.00x | $173.74 | $460.0K | 6.8K | 3.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 12.4K | $2.3M | $182.19 | 2.47x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.2K | $795.9K | $71.06 | 2.11x |
| 92550 | Assessment of eardrum and muscle function | 12.5K | $236.8K | $18.91 | 2.65x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 7.3K | $226.9K | $31.06 | 6.45x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.2K | $195.6K | $89.91 | 2.46x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 6.0K | $178.4K | $29.50 | 5.59x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 4.7K | $167.6K | $35.79 | 2.10x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 3.0K | $98.4K | $33.18 | 4.12x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 936 | $57.6K | $61.51 | 5.94x |
| 69222 | Removal of skin debris and drainage of mastoid cavity | 276 | $55.8K | $202.18 | 1.93x |
| 92585 | Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system | 103 | $12.4K | $120.51 | 2.49x |
| 69210 | Removal of impact ear wax, one ear | 372 | $11.5K | $30.99 | 6.45x |
| 70450 | CT scan head or brain | 262 | $9.5K | $36.30 | 7.13x |
| 92584 | Testing of nerve from ear to brain (cochlear) | 60 | $4.0K | $66.30 | 2.26x |
| 92504 | Diagnostic examination of ear and nose | 139 | $3.7K | $26.58 | 3.76x |
| 92587 | Placement of ear probe for computerized measurement of sound with interpretation and report | 191 | $3.6K | $18.75 | 6.13x |
| 92652 | Evaluation of brain response to sound for determination of hearing threshold with interpretation and report | 11 | $1.2K | $111.11 | 2.25x |
| 94010 | Measurement and graphic recording of total and timed exhaled air capacity | 12 | $391.44 | $32.62 | 3.83x |
This provider submits charges 2.84 times higher than what Medicare actually pays.
A markup ratio of 2.84x means for every $100 Medicare pays, this provider initially charges $284. 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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