This provider's $3.5M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 52% from 2014 to 2023.
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 | $146.74 | $66.69 | 2.20x | $80.05 | $281.0K | 3.6K | 2.6K |
| 2015 | $156.12 | $105.58 | 1.48x | $50.54 | $292.0K | 3.7K | 2.7K |
| 2016 | $149.57 | $88.75 | 1.69x | $60.82 | $313.1K | 4.0K | 3.1K |
| 2017 | $118.68 | $68.43 | 1.73x | $50.25 | $327.4K | 4.5K | 3.4K |
| 2018 | $116.96 | $71.18 | 1.64x | $45.78 | $368.2K | 4.5K | 3.4K |
| 2019 | $116.49 | $70.34 | 1.66x | $46.15 | $388.8K | 5.3K | 3.7K |
| 2020 | $134.90 | $61.58 | 2.19x | $73.32 | $307.5K | 4.5K | 3.4K |
| 2021 | $222.06 | $79.64 | 2.79x | $142.42 | $399.8K | 4.8K | 3.8K |
| 2022 | $209.73 | $70.90 | 2.96x | $138.83 | $348.3K | 4.2K | 3.4K |
| 2023 | $214.17 | $70.66 | 3.03x | $143.51 | $425.7K | 5.2K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 4.7K | $771.5K | $164.92 | 1.77x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 5.9K | $568.9K | $96.26 | 1.69x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.6K | $452.9K | $59.36 | 1.81x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.6K | $449.7K | $126.51 | 2.19x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.0K | $368.1K | $91.38 | 2.02x |
| 70486 | CT scan of face | 2.6K | $283.5K | $108.57 | 3.40x |
| 69210 | Removal of impact ear wax, one ear | 3.6K | $116.9K | $32.84 | 2.20x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.0K | $84.5K | $81.53 | 2.01x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 457 | $72.8K | $159.20 | 1.75x |
| 92511 | Examination of the nose and throat using an endoscope | 551 | $51.5K | $93.45 | 1.93x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.1K | $39.9K | $35.21 | 1.76x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 944 | $36.9K | $39.11 | 1.98x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 3.8K | $31.4K | $8.23 | 2.03x |
| 70480 | CT scan of cranial cavity | 223 | $30.3K | $135.87 | 3.16x |
| 31238 | Control of nasal bleeding using an endoscope | 89 | $18.7K | $210.47 | 2.64x |
| 95165 | Preparation and provision of single or multiple antigens for allergen immunotherapy | 1.0K | $11.8K | $11.56 | 2.19x |
| 95992 | Repositioning maneuvers for treatment of vertigo, per day | 322 | $11.2K | $34.72 | 3.63x |
| 60500 | Removal or exploration of parathyroid glands | 12 | $10.2K | $847.42 | 1.32x |
| 95024 | Injection of allergenic extracts into skin for immediate reaction analysis | 869 | $6.0K | $6.86 | 2.34x |
| 38510 | Biopsy or removal of lymph nodes of neck, open procedure | 11 | $4.0K | $364.42 | 1.64x |
This provider submits charges 2.04 times higher than what Medicare actually pays.
A markup ratio of 2.04x means for every $100 Medicare pays, this provider initially charges $204. 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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