This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 6196% from 2015 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1774% in 2016
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 |
|---|---|---|---|---|---|---|---|
| 2015 | $264.50 | $108.77 | 2.43x | $155.73 | $12.3K | 161 | 124 |
| 2016 | $1.7K | $436.30 | 3.85x | $1.2K | $230.5K | 1.2K | 973 |
| 2017 | $1.9K | $413.23 | 4.54x | $1.5K | $348.0K | 1.4K | 1.1K |
| 2018 | $1.8K | $512.60 | 3.46x | $1.3K | $546.8K | 1.7K | 1.1K |
| 2019 | $1.6K | $459.68 | 3.50x | $1.2K | $543.5K | 1.9K | 1.1K |
| 2020 | $1.8K | $542.81 | 3.39x | $1.3K | $369.6K | 1.2K | 798 |
| 2021 | $2.3K | $769.09 | 2.95x | $1.5K | $308.1K | 1.0K | 755 |
| 2022 | $2.8K | $866.90 | 3.18x | $1.9K | $743.6K | 1.1K | 968 |
| 2023 | $2.0K | $830.43 | 2.42x | $1.2K | $774.7K | 1.2K | 1.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 324 | $1.5M | $4.8K | 2.26x |
| 31295 | Dilation of nasal sinus using an endoscope | 379 | $700.5K | $1.8K | 3.68x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 1.7K | $297.9K | $175.87 | 3.59x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.6K | $165.9K | $64.43 | 3.36x |
| 69706 | Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose | 67 | $163.8K | $2.4K | 2.45x |
| 31233 | Examination of nasal passage and sinus using an endoscope | 476 | $159.2K | $334.50 | 2.10x |
| 31296 | Dilation of nasal sinus using an endoscope | 55 | $155.9K | $2.8K | 2.82x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.1K | $100.8K | $93.11 | 2.68x |
| 30117 | Removal or destruction of growth in nose | 190 | $85.0K | $447.15 | 3.96x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 608 | $82.3K | $135.44 | 2.33x |
| 31297 | Dilation of nasal sinus using an endoscope | 56 | $80.9K | $1.4K | 5.19x |
| 30140 | Removal of nasal air passage | 345 | $70.5K | $204.45 | 7.76x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 741 | $65.0K | $87.70 | 4.37x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 198 | $63.5K | $320.51 | 3.75x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 281 | $45.1K | $160.62 | 3.11x |
| 69210 | Removal of impact ear wax, one ear | 995 | $38.0K | $38.18 | 2.84x |
| 31254 | Partial removal of nasal sinus using an endoscope | 70 | $18.2K | $259.46 | 18.89x |
| 70486 | CT scan of face | 280 | $12.0K | $42.85 | 12.14x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 65 | $6.6K | $101.96 | 2.89x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 116 | $3.8K | $32.34 | 3.09x |
This provider submits charges 3.1 times higher than what Medicare actually pays.
A markup ratio of 3.1x means for every $100 Medicare pays, this provider initially charges $310. 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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