This provider's $9.2M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 146% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 68% 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 |
|---|---|---|---|---|---|---|---|
| 2014 | $1.4K | $376.55 | 3.85x | $1.1K | $464.0K | 2.6K | 2.1K |
| 2015 | $1.3K | $314.20 | 4.12x | $979.47 | $575.5K | 3.3K | 2.5K |
| 2016 | $1.4K | $335.02 | 4.12x | $1.0K | $968.8K | 4.7K | 3.4K |
| 2017 | $1.3K | $310.72 | 4.30x | $1.0K | $837.1K | 4.3K | 3.0K |
| 2018 | $1.2K | $374.55 | 3.28x | $854.26 | $1.2M | 4.8K | 3.4K |
| 2019 | $1.3K | $340.11 | 3.76x | $938.48 | $1.1M | 5.8K | 4.0K |
| 2020 | $1.3K | $380.93 | 3.40x | $914.67 | $842.0K | 4.8K | 3.1K |
| 2021 | $1.3K | $386.88 | 3.40x | $927.68 | $824.9K | 5.8K | 3.6K |
| 2022 | $1.4K | $406.05 | 3.44x | $989.46 | $1.2M | 7.4K | 4.7K |
| 2023 | $1.6K | $417.20 | 3.73x | $1.1K | $1.1M | 7.5K | 4.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 307 | $1.6M | $5.1K | 2.73x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 8.4K | $1.5M | $183.06 | 4.22x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 14.4K | $1.5M | $101.10 | 3.54x |
| 31295 | Dilation of nasal sinus using an endoscope | 622 | $1.1M | $1.8K | 4.56x |
| 31296 | Dilation of nasal sinus using an endoscope | 214 | $623.1K | $2.9K | 2.81x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 2.6K | $470.6K | $177.65 | 4.17x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.3K | $455.2K | $139.59 | 3.91x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.2K | $432.2K | $346.28 | 3.33x |
| 31297 | Dilation of nasal sinus using an endoscope | 198 | $294.4K | $1.5K | 5.44x |
| 69210 | Removal of impact ear wax, one ear | 5.7K | $237.8K | $41.83 | 4.28x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.5K | $220.9K | $142.63 | 3.35x |
| 31238 | Control of nasal bleeding using an endoscope | 396 | $131.3K | $331.66 | 3.54x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.9K | $119.4K | $62.69 | 3.91x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 764 | $69.4K | $90.89 | 3.98x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 308 | $56.9K | $184.73 | 3.64x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.6K | $51.7K | $33.07 | 3.82x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 1.6K | $47.9K | $29.41 | 3.71x |
| 30802 | Destruction of soft tissue in nasal passages | 330 | $43.2K | $131.03 | 8.09x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 443 | $42.6K | $96.22 | 3.52x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 234 | $39.3K | $167.80 | 3.81x |
This provider submits charges 3.75 times higher than what Medicare actually pays.
A markup ratio of 3.75x means for every $100 Medicare pays, this provider initially charges $375. 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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