This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 87% 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 | $333.85 | $101.09 | 3.30x | $232.76 | $236.0K | 2.8K | 1.8K |
| 2015 | $354.34 | $106.09 | 3.34x | $248.25 | $319.9K | 3.5K | 1.9K |
| 2016 | $229.37 | $77.02 | 2.98x | $152.35 | $300.1K | 3.5K | 1.9K |
| 2017 | $275.72 | $89.95 | 3.07x | $185.77 | $327.5K | 3.8K | 2.0K |
| 2018 | $308.02 | $95.59 | 3.22x | $212.43 | $351.8K | 4.0K | 2.2K |
| 2019 | $326.02 | $98.66 | 3.30x | $227.36 | $351.9K | 3.9K | 2.2K |
| 2020 | $270.08 | $93.22 | 2.90x | $176.86 | $270.1K | 3.2K | 1.8K |
| 2021 | $317.69 | $101.34 | 3.13x | $216.35 | $368.8K | 3.9K | 2.1K |
| 2022 | $308.06 | $91.92 | 3.35x | $216.14 | $386.1K | 4.2K | 2.4K |
| 2023 | $308.18 | $91.02 | 3.39x | $217.16 | $440.3K | 4.8K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 7.2K | $1.4M | $191.16 | 2.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.4K | $550.6K | $102.08 | 2.15x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 6.0K | $418.1K | $70.22 | 2.37x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.1K | $236.3K | $110.31 | 2.55x |
| 30200 | Injection of drug into nasal air passages | 3.6K | $201.2K | $56.28 | 4.17x |
| 69210 | Removal of impact ear wax, one ear | 5.0K | $148.5K | $29.75 | 7.77x |
| 31238 | Control of nasal bleeding using an endoscope | 383 | $92.9K | $242.69 | 2.86x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 956 | $90.6K | $94.72 | 2.11x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 2.3K | $76.6K | $34.03 | 2.97x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 155 | $53.4K | $344.40 | 4.78x |
| 92567 | Eardrum testing using ear probe | 3.8K | $52.3K | $13.91 | 4.06x |
| 70486 | CT scan of face | 132 | $12.5K | $95.04 | 5.26x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 368 | $12.2K | $33.09 | 2.45x |
| 92511 | Examination of the nose and throat using an endoscope | 82 | $10.4K | $127.42 | 2.39x |
| 30802 | Destruction of soft tissue in nasal passages | 19 | $5.1K | $266.84 | 1.98x |
| 92504 | Diagnostic examination of ear and nose | 129 | $3.5K | $27.32 | 2.38x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 34 | $2.0K | $60.01 | 2.25x |
| 92512 | Analysis of nasal resistance during breathing | 41 | $2.0K | $49.52 | 3.68x |
| 69401 | Inflation of tube from middle ear to throat through the nose | 28 | $1.3K | $45.20 | 3.45x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 85 | $755.58 | $8.89 | 4.78x |
This provider submits charges 3.04 times higher than what Medicare actually pays.
A markup ratio of 3.04x means for every $100 Medicare pays, this provider initially charges $304. 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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