This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 369% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 106% 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 | $429.86 | $119.98 | 3.58x | $309.88 | $118.1K | 1.3K | 1.1K |
| 2015 | $392.62 | $122.10 | 3.22x | $270.52 | $130.6K | 1.5K | 1.2K |
| 2016 | $405.96 | $111.83 | 3.63x | $294.13 | $176.6K | 2.5K | 1.6K |
| 2017 | $405.62 | $112.51 | 3.61x | $293.11 | $199.8K | 2.7K | 1.9K |
| 2018 | $1.1K | $313.69 | 3.46x | $772.28 | $411.4K | 2.9K | 2.1K |
| 2019 | $1.2K | $356.39 | 3.28x | $810.98 | $328.5K | 2.3K | 1.5K |
| 2020 | $1.1K | $377.69 | 2.92x | $723.92 | $479.6K | 2.4K | 1.5K |
| 2021 | $1.1K | $366.84 | 2.96x | $719.34 | $621.1K | 2.5K | 1.8K |
| 2022 | $1.0K | $345.84 | 2.99x | $686.54 | $505.2K | 2.3K | 1.7K |
| 2023 | $1.1K | $328.11 | 3.31x | $756.78 | $553.9K | 2.7K | 2.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 316 | $1.3M | $4.0K | 2.51x |
| 31295 | Dilation of nasal sinus using an endoscope | 304 | $503.6K | $1.7K | 3.61x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.3K | $351.9K | $82.78 | 2.47x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 2.3K | $271.5K | $117.80 | 2.60x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 1.8K | $256.7K | $144.14 | 2.40x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.5K | $137.9K | $55.68 | 2.45x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 458 | $123.3K | $269.30 | 3.78x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 1.4K | $119.9K | $86.95 | 2.51x |
| 70486 | CT scan of face | 879 | $82.6K | $94.02 | 2.92x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 987 | $71.7K | $72.68 | 2.73x |
| 30140 | Removal of nasal air passage | 303 | $69.1K | $227.93 | 5.24x |
| 61782 | Computer-assisted procedure outside the brain | 312 | $42.3K | $135.43 | 2.94x |
| 31238 | Control of nasal bleeding using an endoscope | 161 | $30.4K | $189.00 | 3.07x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 4.0K | $29.1K | $7.33 | 3.00x |
| 30117 | Removal or destruction of growth in nose | 50 | $28.9K | $578.73 | 4.42x |
| 31255 | Removal of nasal sinus using an endoscope | 142 | $25.1K | $177.05 | 6.32x |
| 30520 | Reshaping of nasal cartilage | 80 | $23.1K | $288.96 | 3.93x |
| 69210 | Removal of impact ear wax, one ear | 556 | $18.3K | $32.98 | 4.73x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 533 | $14.4K | $27.08 | 5.16x |
| 92511 | Examination of the nose and throat using an endoscope | 119 | $10.8K | $91.00 | 2.85x |
This provider submits charges 2.88 times higher than what Medicare actually pays.
A markup ratio of 2.88x means for every $100 Medicare pays, this provider initially charges $288. 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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