This provider's $5.3M 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 | $310.22 | $93.06 | 3.33x | $217.16 | $522.2K | 6.4K | 4.7K |
| 2015 | $242.63 | $83.17 | 2.92x | $159.46 | $477.0K | 5.8K | 4.5K |
| 2016 | $256.41 | $82.85 | 3.09x | $173.56 | $525.9K | 6.6K | 5.1K |
| 2017 | $223.32 | $73.66 | 3.03x | $149.66 | $513.6K | 6.6K | 5.0K |
| 2018 | $258.55 | $80.88 | 3.20x | $177.67 | $579.2K | 7.2K | 5.2K |
| 2019 | $226.14 | $70.88 | 3.19x | $155.26 | $477.1K | 6.0K | 4.4K |
| 2020 | $258.09 | $82.29 | 3.14x | $175.80 | $439.0K | 5.3K | 4.0K |
| 2021 | $271.02 | $90.36 | 3.00x | $180.66 | $612.1K | 6.4K | 4.8K |
| 2022 | $325.05 | $101.69 | 3.20x | $223.36 | $571.3K | 6.1K | 4.6K |
| 2023 | $331.66 | $97.65 | 3.40x | $234.01 | $623.2K | 7.2K | 5.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 10.2K | $2.0M | $193.51 | 3.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 11.7K | $855.5K | $73.20 | 2.18x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 3.3K | $615.1K | $185.94 | 4.18x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 9.6K | $387.9K | $40.37 | 2.07x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.8K | $369.7K | $98.04 | 2.01x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.7K | $309.8K | $112.74 | 3.28x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 8.4K | $288.3K | $34.12 | 4.76x |
| 92550 | Assessment of eardrum and muscle function | 8.2K | $161.0K | $19.65 | 4.23x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 824 | $93.6K | $113.56 | 2.05x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 1.3K | $86.6K | $66.33 | 1.80x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 326 | $49.5K | $151.88 | 1.90x |
| 69222 | Removal of skin debris and drainage of mastoid cavity | 198 | $41.9K | $211.57 | 3.65x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 757 | $22.8K | $30.09 | 7.75x |
| 92587 | Placement of ear probe for computerized measurement of sound with interpretation and report | 832 | $15.9K | $19.17 | 2.15x |
| 69210 | Removal of impact ear wax, one ear | 387 | $15.4K | $39.78 | 2.92x |
| 99442 | Physician telephone patient service, 11-20 minutes of medical discussion | 125 | $9.9K | $78.98 | 1.92x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 95 | $8.5K | $89.47 | 1.75x |
| 92546 | Assessment and recording of abnormal eye movement with patient in a rotating chair | 86 | $8.2K | $94.93 | 1.55x |
| 92567 | Eardrum testing using ear probe | 383 | $5.8K | $15.06 | 5.37x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 21 | $5.0K | $236.22 | 4.35x |
This provider submits charges 3.21 times higher than what Medicare actually pays.
A markup ratio of 3.21x means for every $100 Medicare pays, this provider initially charges $321. 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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