This provider's $7.2M 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 | $243.52 | $89.33 | 2.73x | $154.19 | $574.1K | 7.0K | 5.9K |
| 2015 | $210.63 | $91.97 | 2.29x | $118.66 | $584.9K | 7.2K | 5.9K |
| 2016 | $205.11 | $91.42 | 2.24x | $113.69 | $697.2K | 8.4K | 7.2K |
| 2017 | $603.69 | $334.20 | 1.81x | $269.49 | $756.6K | 8.2K | 7.0K |
| 2018 | $734.65 | $386.70 | 1.90x | $347.95 | $809.3K | 8.8K | 7.4K |
| 2019 | $308.03 | $118.25 | 2.60x | $189.78 | $797.2K | 9.3K | 7.7K |
| 2020 | $166.64 | $94.66 | 1.76x | $71.98 | $647.6K | 7.1K | 5.9K |
| 2021 | $210.11 | $99.23 | 2.12x | $110.88 | $789.5K | 8.0K | 6.4K |
| 2022 | $390.71 | $95.29 | 4.10x | $295.42 | $818.2K | 9.1K | 7.5K |
| 2023 | $390.73 | $88.86 | 4.40x | $301.87 | $683.5K | 8.0K | 6.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 10.0K | $1.9M | $194.35 | 2.07x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.6K | $769.0K | $72.69 | 1.97x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.6K | $728.4K | $109.98 | 2.16x |
| 92511 | Examination of the nose and throat using an endoscope | 6.0K | $672.5K | $112.43 | 2.82x |
| 31238 | Control of nasal bleeding using an endoscope | 1.9K | $457.7K | $243.57 | 3.68x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.2K | $322.8K | $101.53 | 2.03x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 1.6K | $301.9K | $187.17 | 3.57x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.2K | $244.8K | $111.23 | 2.47x |
| 92504 | Diagnostic examination of ear and nose | 7.8K | $221.3K | $28.26 | 3.09x |
| 69210 | Removal of impact ear wax, one ear | 5.4K | $210.8K | $38.91 | 3.02x |
| 30903 | Complex control of nose bleed | 796 | $169.4K | $212.81 | 2.12x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 4.9K | $169.1K | $34.65 | 2.88x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 4.9K | $149.1K | $30.56 | 3.14x |
| 92570 | Detection of middle ear fluid with assessment of eardrum and muscle function | 4.9K | $146.4K | $29.82 | 3.05x |
| 99204 | New patient outpatient visit, total time 45-59 minutes | 627 | $100.2K | $159.83 | 2.58x |
| 92563 | Hearing test using earphones | 3.3K | $99.7K | $29.86 | 2.70x |
| 92512 | Analysis of nasal resistance during breathing | 1.5K | $86.5K | $57.45 | 1.87x |
| 92585 | Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system | 569 | $72.8K | $127.92 | 2.04x |
| 31298 | Dilation of nasal sinus using an endoscope | 12 | $63.6K | $5.3K | 1.38x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 1.9K | $61.5K | $32.72 | 4.03x |
This provider submits charges 2.47 times higher than what Medicare actually pays.
A markup ratio of 2.47x means for every $100 Medicare pays, this provider initially charges $247. 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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