This provider's $5.3M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 111% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 130% 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 | $1.0K | $262.28 | 3.93x | $769.25 | $298.0K | 2.8K | 2.3K |
| 2015 | $583.24 | $137.23 | 4.25x | $446.01 | $253.4K | 3.1K | 2.5K |
| 2016 | $1.6K | $328.40 | 4.94x | $1.3K | $583.0K | 2.4K | 1.9K |
| 2017 | $1.7K | $308.40 | 5.62x | $1.4K | $565.9K | 2.8K | 2.3K |
| 2018 | $1.6K | $373.48 | 4.32x | $1.2K | $608.7K | 2.3K | 1.7K |
| 2019 | $1.5K | $352.58 | 4.36x | $1.2K | $640.4K | 3.1K | 2.4K |
| 2020 | $1.6K | $428.65 | 3.82x | $1.2K | $569.5K | 2.2K | 1.8K |
| 2021 | $1.5K | $409.29 | 3.70x | $1.1K | $621.8K | 2.0K | 1.5K |
| 2022 | $1.3K | $385.26 | 3.44x | $941.86 | $504.9K | 1.8K | 1.3K |
| 2023 | $1.1K | $370.37 | 2.91x | $708.16 | $629.2K | 2.4K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 412 | $1.7M | $4.1K | 3.38x |
| 31295 | Dilation of nasal sinus using an endoscope | 584 | $869.3K | $1.5K | 4.53x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 4.9K | $753.8K | $154.37 | 2.05x |
| 31296 | Dilation of nasal sinus using an endoscope | 175 | $420.4K | $2.4K | 4.27x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.1K | $283.4K | $55.50 | 2.17x |
| 31297 | Dilation of nasal sinus using an endoscope | 157 | $190.5K | $1.2K | 7.26x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.5K | $189.3K | $74.94 | 2.90x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 924 | $110.3K | $119.38 | 2.71x |
| 30140 | Removal of nasal air passage | 381 | $89.9K | $235.92 | 6.79x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 344 | $89.3K | $259.47 | 3.42x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 899 | $80.7K | $89.77 | 2.81x |
| 70486 | CT scan of face | 548 | $60.5K | $110.40 | 6.66x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 688 | $58.4K | $84.94 | 2.43x |
| 31254 | Partial removal of nasal sinus using an endoscope | 241 | $49.3K | $204.44 | 6.45x |
| 69210 | Removal of impact ear wax, one ear | 1.5K | $47.4K | $30.89 | 3.23x |
| 61782 | Computer-assisted procedure outside the brain | 325 | $46.1K | $141.77 | 5.06x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.5K | $41.2K | $26.91 | 4.85x |
| 30520 | Reshaping of nasal cartilage | 119 | $34.3K | $288.63 | 4.57x |
| 31276 | Exploration of nasal sinus using an endoscope | 48 | $25.3K | $527.38 | 5.12x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 681 | $24.6K | $36.11 | 2.77x |
This provider submits charges 3.65 times higher than what Medicare actually pays.
A markup ratio of 3.65x means for every $100 Medicare pays, this provider initially charges $365. 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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