This provider's $7.0M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 263% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 200% in 2018
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
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 | $259.82 | $86.39 | 3.01x | $173.43 | $288.3K | 2.4K | 1.5K |
| 2015 | $286.64 | $94.96 | 3.02x | $191.68 | $258.3K | 2.4K | 1.4K |
| 2016 | $274.67 | $91.44 | 3.00x | $183.23 | $256.9K | 2.5K | 1.6K |
| 2017 | $284.26 | $94.40 | 3.01x | $189.86 | $239.2K | 2.6K | 1.7K |
| 2018 | $585.57 | $327.83 | 1.79x | $257.74 | $717.8K | 3.2K | 2.4K |
| 2019 | $600.36 | $332.54 | 1.81x | $267.82 | $821.4K | 3.4K | 2.4K |
| 2020 | $648.22 | $379.41 | 1.71x | $268.81 | $1.2M | 2.9K | 2.2K |
| 2021 | $677.94 | $426.25 | 1.59x | $251.69 | $1.1M | 2.2K | 1.6K |
| 2022 | $710.19 | $423.36 | 1.68x | $286.83 | $1.1M | 2.6K | 1.8K |
| 2023 | $634.41 | $393.69 | 1.61x | $240.72 | $1.0M | 2.8K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 653 | $3.3M | $5.0K | 1.35x |
| 31295 | Dilation of nasal sinus using an endoscope | 652 | $1.1M | $1.8K | 1.28x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.4K | $428.3K | $298.24 | 4.05x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.3K | $361.2K | $159.91 | 2.41x |
| 31525 | Diagnostic examination of voice box using an endoscope | 1.8K | $344.5K | $195.62 | 2.30x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.9K | $301.9K | $102.96 | 2.04x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.5K | $264.9K | $58.32 | 2.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $172.3K | $134.83 | 2.54x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $90.1K | $81.53 | 3.37x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 528 | $89.7K | $169.84 | 2.64x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 928 | $87.1K | $93.83 | 2.72x |
| 30117 | Removal or destruction of growth in nose | 114 | $79.2K | $694.65 | 2.88x |
| 92520 | Functional assessment of the voice box | 1.0K | $72.3K | $69.10 | 2.17x |
| 69210 | Removal of impact ear wax, one ear | 2.0K | $68.6K | $34.06 | 2.93x |
| 70486 | CT scan of face | 660 | $50.2K | $76.14 | 5.73x |
| 99233 | Subsequent hospital inpatient care, typically 35 minutes per day | 410 | $35.8K | $87.34 | 2.86x |
| 31238 | Control of nasal bleeding using an endoscope | 130 | $28.3K | $217.40 | 2.76x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 209 | $27.3K | $130.53 | 2.69x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 2.2K | $19.9K | $8.96 | 3.35x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 61 | $10.0K | $163.67 | 2.14x |
This provider submits charges 1.87 times higher than what Medicare actually pays.
A markup ratio of 1.87x means for every $100 Medicare pays, this provider initially charges $187. This is lower 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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