This provider's $6.6M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 138% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 122% in 2017
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 | $2.3K | $486.56 | 4.83x | $1.9K | $276.0K | 725 | 620 |
| 2015 | $2.2K | $445.43 | 4.91x | $1.7K | $408.7K | 914 | 808 |
| 2016 | $1.2K | $356.49 | 3.38x | $847.71 | $400.1K | 1.1K | 969 |
| 2017 | $1.1K | $349.47 | 3.09x | $731.19 | $888.6K | 2.3K | 2.0K |
| 2018 | $1.6K | $457.89 | 3.56x | $1.2K | $1.0M | 2.1K | 1.9K |
| 2019 | $2.0K | $580.85 | 3.40x | $1.4K | $927.5K | 2.4K | 1.9K |
| 2020 | $2.3K | $590.29 | 3.97x | $1.8K | $747.8K | 1.9K | 1.5K |
| 2021 | $2.2K | $532.09 | 4.11x | $1.7K | $604.2K | 2.0K | 1.6K |
| 2022 | $2.0K | $481.23 | 4.26x | $1.6K | $680.1K | 2.5K | 2.0K |
| 2023 | $2.0K | $465.40 | 4.20x | $1.5K | $655.9K | 2.3K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 497 | $2.2M | $4.5K | 3.39x |
| 31295 | Dilation of nasal sinus using an endoscope | 817 | $1.2M | $1.5K | 4.22x |
| 31296 | Dilation of nasal sinus using an endoscope | 328 | $795.1K | $2.4K | 2.55x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.7K | $420.6K | $156.08 | 3.48x |
| 70486 | CT scan of face | 3.5K | $385.8K | $111.77 | 4.12x |
| 31297 | Dilation of nasal sinus using an endoscope | 293 | $354.1K | $1.2K | 4.78x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 930 | $272.8K | $293.29 | 3.20x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $187.3K | $113.24 | 3.83x |
| 30140 | Removal of nasal air passage | 754 | $153.6K | $203.69 | 5.32x |
| 30520 | Reshaping of nasal cartilage | 559 | $144.2K | $257.90 | 6.93x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 2.3K | $133.9K | $57.62 | 3.66x |
| 69801 | Incision of fluid canals of inner ear with infusion of drugs, transcanal approach | 349 | $56.6K | $162.05 | 4.25x |
| 95806 | Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort | 383 | $41.5K | $108.32 | 3.11x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 519 | $38.9K | $74.95 | 4.09x |
| 77011 | Ct scan guidance for stereotactic localization | 202 | $38.5K | $190.80 | 3.83x |
| 30117 | Removal or destruction of growth in nose | 59 | $31.1K | $526.69 | 5.14x |
| 95800 | Study of sleep patterns, including sleep time | 225 | $28.3K | $125.75 | 4.01x |
| 61782 | Computer-assisted procedure outside the brain | 203 | $27.5K | $135.65 | 3.81x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 213 | $19.5K | $91.72 | 3.60x |
| 42145 | Removal of soft tissue at roof of mouth | 70 | $18.9K | $270.66 | 5.32x |
This provider submits charges 3.73 times higher than what Medicare actually pays.
A markup ratio of 3.73x means for every $100 Medicare pays, this provider initially charges $373. 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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