This provider's $5.3M 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 | $1.4K | $287.81 | 4.72x | $1.1K | $437.8K | 3.4K | 2.6K |
| 2015 | $1.6K | $303.97 | 5.11x | $1.2K | $477.0K | 3.6K | 2.5K |
| 2016 | $1.7K | $330.01 | 5.16x | $1.4K | $493.9K | 3.5K | 2.5K |
| 2017 | $1.8K | $341.08 | 5.37x | $1.5K | $563.9K | 3.4K | 2.5K |
| 2018 | $1.6K | $381.74 | 4.06x | $1.2K | $649.2K | 3.3K | 2.3K |
| 2019 | $1.6K | $389.32 | 4.22x | $1.3K | $667.2K | 3.4K | 2.4K |
| 2020 | $1.7K | $447.84 | 3.75x | $1.2K | $506.3K | 2.7K | 2.0K |
| 2021 | $1.6K | $415.38 | 3.78x | $1.2K | $535.5K | 3.4K | 2.5K |
| 2022 | $1.3K | $317.29 | 4.15x | $1.0K | $570.6K | 4.5K | 3.3K |
| 2023 | $1.3K | $307.72 | 4.35x | $1.0K | $425.8K | 3.7K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 206 | $972.6K | $4.7K | 3.60x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.3K | $614.5K | $59.80 | 1.87x |
| 31295 | Dilation of nasal sinus using an endoscope | 360 | $546.2K | $1.5K | 5.99x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.7K | $539.9K | $319.48 | 4.28x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.1K | $506.2K | $163.19 | 2.32x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 4.4K | $423.9K | $96.34 | 2.64x |
| 31296 | Dilation of nasal sinus using an endoscope | 154 | $393.4K | $2.6K | 4.82x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.9K | $309.9K | $78.67 | 2.63x |
| 31238 | Control of nasal bleeding using an endoscope | 826 | $178.9K | $216.57 | 3.52x |
| 31297 | Dilation of nasal sinus using an endoscope | 127 | $161.4K | $1.3K | 7.05x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 703 | $85.7K | $121.85 | 2.40x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 519 | $82.3K | $158.65 | 3.21x |
| 30140 | Removal of nasal air passage | 383 | $78.3K | $204.50 | 7.96x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 907 | $72.0K | $79.43 | 2.22x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 274 | $48.4K | $176.56 | 2.57x |
| 92504 | Diagnostic examination of ear and nose | 1.7K | $37.7K | $22.80 | 2.06x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.0K | $34.4K | $33.90 | 2.45x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 586 | $34.3K | $58.48 | 2.00x |
| 69210 | Removal of impact ear wax, one ear | 978 | $34.2K | $34.97 | 3.00x |
| 69420 | Incision, aspiration, and/or inflation of eardrum | 191 | $31.8K | $166.54 | 2.70x |
This provider submits charges 3.64 times higher than what Medicare actually pays.
A markup ratio of 3.64x means for every $100 Medicare pays, this provider initially charges $364. 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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