This provider's $6.5M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 102% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 83% in 2022
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 | $1.2K | $216.98 | 5.71x | $1.0K | $545.9K | 4.0K | 2.9K |
| 2015 | $1.3K | $225.45 | 5.78x | $1.1K | $453.6K | 4.3K | 2.7K |
| 2016 | $1.4K | $235.72 | 5.98x | $1.2K | $441.3K | 5.2K | 2.9K |
| 2017 | $1.4K | $213.61 | 6.75x | $1.2K | $461.8K | 4.8K | 2.9K |
| 2018 | $1.6K | $288.07 | 5.51x | $1.3K | $469.8K | 4.3K | 2.7K |
| 2019 | $1.0K | $232.34 | 4.37x | $783.58 | $655.0K | 4.1K | 2.7K |
| 2020 | $881.52 | $250.32 | 3.52x | $631.20 | $609.0K | 3.9K | 2.6K |
| 2021 | $907.61 | $255.33 | 3.55x | $652.28 | $610.8K | 4.2K | 2.8K |
| 2022 | $1.8K | $478.87 | 3.67x | $1.3K | $1.1M | 5.2K | 3.4K |
| 2023 | $1.8K | $480.13 | 3.83x | $1.4K | $1.1M | 5.1K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 312 | $1.2M | $3.8K | 2.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.2K | $802.2K | $78.36 | 4.76x |
| J3490 | Unclassified drugs | 122 | $761.1K | $6.2K | 3.98x |
| 31295 | Dilation of nasal sinus using an endoscope | 500 | $737.1K | $1.5K | 4.46x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.3K | $450.9K | $137.26 | 5.13x |
| 31296 | Dilation of nasal sinus using an endoscope | 154 | $337.4K | $2.2K | 3.78x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.3K | $332.4K | $255.12 | 4.94x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.8K | $226.5K | $81.73 | 4.72x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $149.2K | $113.73 | 4.86x |
| 31297 | Dilation of nasal sinus using an endoscope | 108 | $126.0K | $1.2K | 7.00x |
| 30520 | Reshaping of nasal cartilage | 416 | $121.8K | $292.71 | 6.67x |
| 30117 | Removal or destruction of growth in nose | 233 | $121.5K | $521.60 | 5.59x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.4K | $96.7K | $70.21 | 5.66x |
| 31254 | Partial removal of nasal sinus using an endoscope | 347 | $87.5K | $252.10 | 4.53x |
| 69705 | Dilation of canal between middle ear and throat (eustachian tube) on one side of body, using endoscope inserted through nose | 41 | $83.7K | $2.0K | 3.04x |
| 69706 | Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose | 31 | $66.7K | $2.2K | 3.73x |
| 70486 | CT scan of face | 918 | $66.5K | $72.45 | 7.02x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.1K | $62.0K | $54.56 | 4.34x |
| 30802 | Destruction of soft tissue in nasal passages | 523 | $58.3K | $111.49 | 8.74x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 7.6K | $55.1K | $7.26 | 4.84x |
This provider submits charges 4.52 times higher than what Medicare actually pays.
A markup ratio of 4.52x means for every $100 Medicare pays, this provider initially charges $452. 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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