This provider averages 51 services per working day
Based on 126.4K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $6.1M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Averaging 51 services per working day raises questions about billing patterns.
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 | $1.0K | $268.94 | 3.87x | $771.48 | $949.8K | 17.5K | 5.7K |
| 2015 | $454.96 | $123.18 | 3.69x | $331.78 | $770.1K | 16.6K | 5.2K |
| 2016 | $696.84 | $244.21 | 2.85x | $452.63 | $633.0K | 14.5K | 5.2K |
| 2017 | $400.64 | $119.17 | 3.36x | $281.47 | $614.6K | 12.7K | 5.2K |
| 2018 | $362.69 | $102.62 | 3.53x | $260.07 | $598.0K | 12.3K | 5.3K |
| 2019 | $320.07 | $94.25 | 3.40x | $225.82 | $617.5K | 12.5K | 5.5K |
| 2020 | $376.74 | $126.02 | 2.99x | $250.72 | $552.4K | 11.7K | 5.0K |
| 2021 | $360.51 | $113.35 | 3.18x | $247.16 | $557.7K | 10.5K | 4.6K |
| 2022 | $356.34 | $114.38 | 3.12x | $241.96 | $473.7K | 9.6K | 4.1K |
| 2023 | $196.91 | $67.66 | 2.91x | $129.25 | $363.5K | 8.5K | 3.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 17.5K | $1.4M | $79.53 | 2.59x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 8.6K | $1.3M | $155.08 | 2.46x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 7.2K | $638.8K | $89.27 | 2.92x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.5K | $523.4K | $54.90 | 2.72x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.1K | $474.0K | $116.59 | 2.68x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 39.0K | $297.2K | $7.61 | 4.06x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 979 | $284.9K | $291.03 | 2.36x |
| 31233 | Examination of nasal passage and sinus using an endoscope | 680 | $202.0K | $297.08 | 2.58x |
| 69210 | Removal of impact ear wax, one ear | 4.1K | $123.3K | $29.81 | 3.35x |
| 95115 | Injection of incremental dosages of allergen | 16.4K | $103.7K | $6.34 | 3.73x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.3K | $100.3K | $75.66 | 2.85x |
| 95165 | Preparation and provision of single or multiple antigens for allergen immunotherapy | 8.9K | $88.7K | $9.99 | 2.46x |
| 31276 | Exploration of nasal sinus using an endoscope | 189 | $88.1K | $465.92 | 2.43x |
| 31296 | Dilation of nasal sinus using an endoscope | 30 | $73.7K | $2.5K | 2.95x |
| 31238 | Control of nasal bleeding using an endoscope | 315 | $64.7K | $205.55 | 2.64x |
| 30520 | Reshaping of nasal cartilage | 172 | $53.6K | $311.38 | 4.05x |
| 30140 | Removal of nasal air passage | 220 | $44.8K | $203.71 | 5.33x |
| 11000 | Removal of inflamed or infected skin, up to 10% of body surface | 1.1K | $41.2K | $39.23 | 2.87x |
| 31295 | Dilation of nasal sinus using an endoscope | 31 | $38.3K | $1.2K | 4.44x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 103 | $18.8K | $182.08 | 4.79x |
This provider submits charges 2.79 times higher than what Medicare actually pays.
A markup ratio of 2.79x means for every $100 Medicare pays, this provider initially charges $279. 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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