This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 72% from 2014 to 2023.
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 | $140.28 | $60.47 | 2.32x | $79.81 | $231.0K | 4.3K | 3.8K |
| 2015 | $156.75 | $63.12 | 2.48x | $93.63 | $254.3K | 4.2K | 3.6K |
| 2016 | $184.05 | $63.48 | 2.90x | $120.57 | $287.3K | 4.8K | 4.1K |
| 2017 | $243.61 | $89.84 | 2.71x | $153.77 | $342.9K | 5.6K | 4.7K |
| 2018 | $227.77 | $82.87 | 2.75x | $144.90 | $394.3K | 6.8K | 5.7K |
| 2019 | $267.25 | $94.81 | 2.82x | $172.44 | $397.5K | 6.9K | 5.6K |
| 2020 | $216.34 | $74.73 | 2.89x | $141.61 | $350.8K | 6.5K | 5.4K |
| 2021 | $238.85 | $73.79 | 3.24x | $165.06 | $351.3K | 6.3K | 5.3K |
| 2022 | $292.32 | $73.88 | 3.96x | $218.44 | $374.3K | 6.8K | 5.8K |
| 2023 | $264.77 | $76.39 | 3.47x | $188.38 | $397.1K | 6.0K | 5.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.2K | $679.4K | $55.73 | 2.01x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.9K | $592.8K | $120.16 | 1.76x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.0K | $435.3K | $86.57 | 1.79x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 3.2K | $254.9K | $78.71 | 2.25x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.5K | $183.4K | $73.90 | 2.13x |
| 92553 | Pure tone air and bone conduction hearing assessment | 6.5K | $181.1K | $27.76 | 1.89x |
| 92585 | Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system | 1.7K | $173.4K | $103.18 | 2.68x |
| 95992 | Repositioning maneuvers for treatment of vertigo, per day | 3.6K | $117.5K | $32.55 | 5.13x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 3.8K | $101.4K | $26.40 | 3.72x |
| 69801 | Incision of fluid canals of inner ear with infusion of drugs, transcanal approach | 532 | $86.7K | $162.93 | 4.98x |
| 92537 | Assessment and recording of balance system during hot and cold irrigation of both ears | 1.9K | $60.0K | $31.97 | 2.58x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 342 | $54.7K | $160.02 | 3.24x |
| 92604 | Analysis and reprogramming of inner ear (cochlear) implant, patient age 7 years or older | 810 | $52.9K | $65.37 | 3.35x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 514 | $45.6K | $88.81 | 2.35x |
| 92567 | Eardrum testing using ear probe | 3.7K | $43.7K | $11.87 | 3.21x |
| 92584 | Testing of nerve from ear to brain (cochlear) | 499 | $33.3K | $66.73 | 3.44x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 934 | $31.2K | $33.38 | 1.69x |
| 69210 | Removal of impact ear wax, one ear | 934 | $30.8K | $32.95 | 4.70x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 208 | $29.5K | $142.04 | 1.77x |
| 92653 | Evaluation of brain response to sound for diagnosis of nervous system disorders with interpretation and report | 425 | $28.5K | $67.05 | 3.82x |
This provider submits charges 2.41 times higher than what Medicare actually pays.
A markup ratio of 2.41x means for every $100 Medicare pays, this provider initially charges $241. 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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