This provider's $3.8M 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.
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 | $219.13 | $92.43 | 2.37x | $126.70 | $266.0K | 3.3K | 2.6K |
| 2015 | $551.69 | $132.40 | 4.17x | $419.29 | $313.5K | 3.8K | 3.0K |
| 2016 | $486.92 | $118.04 | 4.13x | $368.88 | $385.2K | 4.7K | 3.5K |
| 2017 | $1.3K | $161.46 | 7.88x | $1.1K | $423.5K | 5.1K | 4.0K |
| 2018 | $539.90 | $125.01 | 4.32x | $414.89 | $389.5K | 4.8K | 3.9K |
| 2019 | $536.00 | $142.16 | 3.77x | $393.84 | $461.3K | 5.3K | 4.5K |
| 2020 | $262.97 | $97.56 | 2.70x | $165.41 | $394.3K | 4.5K | 3.9K |
| 2021 | $264.62 | $100.83 | 2.62x | $163.79 | $405.1K | 4.3K | 3.7K |
| 2022 | $276.05 | $100.95 | 2.73x | $175.10 | $379.9K | 4.1K | 3.6K |
| 2023 | $431.66 | $108.83 | 3.97x | $322.83 | $395.5K | 4.5K | 4.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31575 | Diagnostic examination of voice box using flexible endoscope | 9.6K | $993.5K | $103.62 | 4.64x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 8.4K | $721.6K | $85.45 | 2.09x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.6K | $647.5K | $177.45 | 2.70x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 9.1K | $572.1K | $62.96 | 1.89x |
| 30903 | Complex control of nose bleed | 1.6K | $321.7K | $195.31 | 2.39x |
| 92625 | Hearing assessment of abnormal sounds | 1.8K | $108.2K | $60.29 | 3.25x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 3.0K | $94.7K | $31.46 | 4.77x |
| 92563 | Hearing test using earphones | 3.0K | $84.8K | $28.15 | 2.49x |
| 92570 | Detection of middle ear fluid with assessment of eardrum and muscle function | 3.0K | $82.2K | $27.09 | 5.54x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 455 | $74.5K | $163.81 | 2.67x |
| 30520 | Reshaping of nasal cartilage | 75 | $27.9K | $371.76 | 7.39x |
| 30140 | Removal of nasal air passage | 76 | $19.6K | $258.32 | 5.22x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 160 | $13.4K | $83.61 | 1.80x |
| 31276 | Exploration of nasal sinus using an endoscope | 19 | $11.5K | $603.07 | 6.63x |
| 30905 | Control of nose bleed and insertion of packing | 32 | $9.6K | $299.41 | 1.67x |
| 31600 | Incision of windpipe for insertion of breathing tube (older than 2 years) | 24 | $6.0K | $251.57 | 7.02x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 43 | $5.3K | $123.54 | 2.01x |
| 31255 | Removal of nasal sinus using an endoscope | 20 | $4.9K | $243.30 | 16.03x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 20 | $3.7K | $186.78 | 18.79x |
| 61781 | Computer-assisted procedure inside the brain | 19 | $3.6K | $187.09 | 8.02x |
This provider submits charges 3.18 times higher than what Medicare actually pays.
A markup ratio of 3.18x means for every $100 Medicare pays, this provider initially charges $318. 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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