This provider's $4.6M 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 | $738.44 | $280.92 | 2.63x | $457.52 | $458.4K | 1.5K | 1.3K |
| 2015 | $719.07 | $238.90 | 3.01x | $480.17 | $442.3K | 1.5K | 1.3K |
| 2016 | $780.90 | $264.36 | 2.95x | $516.54 | $458.8K | 1.6K | 1.3K |
| 2017 | $751.49 | $246.42 | 3.05x | $505.07 | $441.5K | 1.5K | 1.3K |
| 2018 | $847.82 | $277.65 | 3.05x | $570.17 | $449.4K | 1.5K | 1.3K |
| 2019 | $782.74 | $260.35 | 3.01x | $522.39 | $434.6K | 1.5K | 1.3K |
| 2020 | $782.17 | $255.53 | 3.06x | $526.64 | $462.5K | 1.5K | 1.3K |
| 2021 | $850.31 | $277.30 | 3.07x | $573.01 | $423.1K | 1.3K | 1.2K |
| 2022 | $817.88 | $277.72 | 2.94x | $540.16 | $457.6K | 1.4K | 1.2K |
| 2023 | $865.65 | $303.83 | 2.85x | $561.82 | $541.3K | 1.6K | 1.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 17311 | Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks) | 3.3K | $1.1M | $327.30 | 4.37x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 1.4K | $884.2K | $644.01 | 2.53x |
| 14040 | Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 1.2K | $793.1K | $634.96 | 2.50x |
| 17312 | Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals | 1.8K | $609.7K | $339.88 | 2.52x |
| 17313 | Removal and microscopic examination of growth of the trunk, arms, or legs (first stage, up to 5 tissue blocks) | 650 | $293.4K | $451.39 | 2.99x |
| 14020 | Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs | 208 | $121.0K | $581.91 | 2.48x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.5K | $120.1K | $81.69 | 2.76x |
| 13121 | Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs | 392 | $99.9K | $254.94 | 3.59x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 676 | $88.5K | $130.87 | 2.68x |
| 17314 | Removal and microscopic examination of growth of the trunk, arms, or legs | 248 | $81.3K | $328.00 | 2.49x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.3K | $73.9K | $58.50 | 2.51x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 351 | $58.9K | $167.93 | 2.65x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 516 | $50.1K | $97.15 | 2.70x |
| 13132 | Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 140 | $39.7K | $283.84 | 3.85x |
| 13101 | Repair of wound (2.6 to 7.5 centimeters) of trunk | 146 | $38.1K | $261.23 | 3.03x |
| 13131 | Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 154 | $26.3K | $170.89 | 4.83x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 28 | $23.4K | $836.03 | 2.41x |
| 14041 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 25 | $19.5K | $779.97 | 2.54x |
| 13120 | Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs | 118 | $18.9K | $160.38 | 4.75x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 385 | $13.6K | $35.30 | 2.70x |
This provider submits charges 3.07 times higher than what Medicare actually pays.
A markup ratio of 3.07x means for every $100 Medicare pays, this provider initially charges $307. 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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