This provider's $4.9M 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 | $1.2K | $249.38 | 4.61x | $901.14 | $403.3K | 2.9K | 1.7K |
| 2015 | $1.2K | $276.17 | 4.48x | $961.11 | $432.9K | 2.5K | 1.7K |
| 2016 | $1.4K | $313.59 | 4.39x | $1.1K | $433.3K | 1.7K | 1.4K |
| 2017 | $1.6K | $359.31 | 4.53x | $1.3K | $447.9K | 1.8K | 1.5K |
| 2018 | $1.6K | $346.53 | 4.51x | $1.2K | $474.8K | 1.8K | 1.6K |
| 2019 | $1.5K | $359.79 | 4.30x | $1.2K | $545.8K | 2.1K | 1.8K |
| 2020 | $1.5K | $361.38 | 4.24x | $1.2K | $523.7K | 1.9K | 1.6K |
| 2021 | $1.6K | $374.53 | 4.28x | $1.2K | $591.4K | 2.1K | 1.8K |
| 2022 | $1.7K | $367.52 | 4.62x | $1.3K | $572.4K | 2.1K | 1.8K |
| 2023 | $1.8K | $360.21 | 4.93x | $1.4K | $476.7K | 1.7K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 15004 | Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children) | 3.4K | $1.1M | $313.39 | 3.90x |
| 14060 | Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips | 1.2K | $707.2K | $574.02 | 4.12x |
| 14040 | Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet | 1.1K | $551.0K | $519.79 | 4.47x |
| 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 | 718 | $503.2K | $700.87 | 4.10x |
| 14061 | Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of eyelids, nose, ears, and/or lips | 481 | $377.9K | $785.76 | 3.93x |
| 14301 | Tissue transfer repair of wound (30.1 to 60.0 sq centimeters) | 577 | $366.3K | $634.75 | 5.22x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.2K | $253.8K | $79.08 | 4.12x |
| 15731 | Creation of flap graft to nose, forehead, temple, or scalp | 229 | $198.0K | $864.64 | 4.03x |
| 15260 | Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less) | 213 | $165.0K | $774.77 | 3.97x |
| 15576 | Creation of flap graft to eyelids, nose, ears, lips, or mouth | 394 | $163.8K | $415.84 | 5.92x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.8K | $150.6K | $54.54 | 3.96x |
| 15630 | Transfer of skin flap to eyelids, nose, ears, or lips | 495 | $91.6K | $184.99 | 7.52x |
| 11642 | Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips | 408 | $81.2K | $199.10 | 4.10x |
| 14302 | Tissue transfer repair of wound (30.0 sq centimeters) | 346 | $62.7K | $181.30 | 3.92x |
| 11643 | Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips | 176 | $42.9K | $243.73 | 3.97x |
| 11641 | Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips | 165 | $27.5K | $166.78 | 4.29x |
| 13151 | Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips | 129 | $23.1K | $179.29 | 7.12x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 1.3K | $17.6K | $13.86 | 5.09x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 71 | $10.9K | $153.89 | 3.74x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 1.3K | $9.4K | $7.29 | 5.07x |
This provider submits charges 4.31 times higher than what Medicare actually pays.
A markup ratio of 4.31x means for every $100 Medicare pays, this provider initially charges $431. 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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