This provider's $3.9M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 99% in 2020
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 | $1.5K | $337.78 | 4.45x | $1.2K | $344.1K | 2.4K | 1.5K |
| 2015 | $1.7K | $339.96 | 5.10x | $1.4K | $371.4K | 3.5K | 2.0K |
| 2016 | $1.6K | $355.25 | 4.64x | $1.3K | $364.1K | 5.6K | 2.5K |
| 2017 | $1.7K | $357.18 | 4.79x | $1.4K | $381.3K | 2.3K | 1.7K |
| 2018 | $2.7K | $551.83 | 4.94x | $2.2K | $324.8K | 1.4K | 845 |
| 2019 | $2.5K | $567.36 | 4.38x | $1.9K | $247.9K | 1.0K | 677 |
| 2020 | $2.5K | $649.92 | 3.92x | $1.9K | $492.1K | 824 | 768 |
| 2021 | $2.1K | $522.08 | 3.96x | $1.5K | $408.4K | 1.1K | 847 |
| 2022 | $2.1K | $479.41 | 4.31x | $1.6K | $479.0K | 1.9K | 1.2K |
| 2023 | $1.7K | $388.12 | 4.51x | $1.4K | $501.6K | 2.3K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 330 | $1.3M | $4.0K | 3.27x |
| 31295 | Dilation of nasal sinus using an endoscope | 517 | $785.3K | $1.5K | 3.88x |
| 31296 | Dilation of nasal sinus using an endoscope | 178 | $424.0K | $2.4K | 3.46x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.1K | $313.9K | $149.22 | 2.61x |
| 31297 | Dilation of nasal sinus using an endoscope | 155 | $182.6K | $1.2K | 6.39x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.4K | $151.0K | $104.96 | 2.92x |
| 70486 | CT scan of face | 1.3K | $129.5K | $101.45 | 5.71x |
| 30140 | Removal of nasal air passage | 567 | $109.6K | $193.22 | 6.18x |
| 30520 | Reshaping of nasal cartilage | 408 | $107.4K | $263.12 | 7.62x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 301 | $85.5K | $283.94 | 4.94x |
| 30117 | Removal or destruction of growth in nose | 139 | $62.1K | $446.86 | 6.26x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 691 | $54.9K | $79.47 | 2.62x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 7.1K | $50.6K | $7.10 | 4.62x |
| 95165 | Preparation and provision of single or multiple antigens for allergen immunotherapy | 3.2K | $32.4K | $10.05 | 2.29x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 657 | $31.9K | $48.51 | 3.06x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 235 | $15.7K | $66.97 | 2.98x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 28 | $13.0K | $464.20 | 3.55x |
| 31255 | Complete removal of nasal sinus using an endoscope | 87 | $12.4K | $142.33 | 35.13x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 85 | $7.3K | $86.28 | 4.35x |
| 95024 | Injection of allergenic extracts into skin for immediate reaction analysis | 1.2K | $6.9K | $5.65 | 2.39x |
This provider submits charges 3.97 times higher than what Medicare actually pays.
A markup ratio of 3.97x means for every $100 Medicare pays, this provider initially charges $397. 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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