This provider's $5.0M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 198% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 76% in 2015
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 | $266.22 | $89.11 | 2.99x | $177.11 | $296.6K | 5.3K | 3.5K |
| 2015 | $563.10 | $195.57 | 2.88x | $367.53 | $521.5K | 5.1K | 3.5K |
| 2016 | $589.10 | $207.65 | 2.84x | $381.45 | $501.9K | 5.2K | 3.4K |
| 2017 | $570.17 | $182.79 | 3.12x | $387.38 | $308.2K | 4.9K | 3.1K |
| 2018 | $530.42 | $237.23 | 2.24x | $293.19 | $421.4K | 5.0K | 3.5K |
| 2019 | $601.31 | $235.21 | 2.56x | $366.10 | $465.8K | 5.4K | 3.4K |
| 2020 | $605.51 | $259.62 | 2.33x | $345.89 | $443.7K | 5.4K | 3.6K |
| 2021 | $635.34 | $295.18 | 2.15x | $340.16 | $579.9K | 6.0K | 3.9K |
| 2022 | $660.22 | $284.46 | 2.32x | $375.76 | $573.1K | 6.6K | 4.3K |
| 2023 | $647.13 | $294.05 | 2.20x | $353.08 | $884.2K | 7.1K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 6.8K | $529.3K | $78.06 | 1.67x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.5K | $524.0K | $149.54 | 1.54x |
| 31298 | Dilation of nasal sinus using an endoscope | 123 | $512.4K | $4.2K | 1.68x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.8K | $430.7K | $54.99 | 1.82x |
| 30469 | Repair of collapsed nasal valve | 165 | $326.3K | $2.0K | 1.52x |
| 31295 | Dilation of nasal sinus using an endoscope | 227 | $318.8K | $1.4K | 3.56x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.8K | $276.9K | $72.22 | 2.01x |
| 31296 | Dilation of nasal sinus using an endoscope | 109 | $264.7K | $2.4K | 2.07x |
| 76536 | Ultrasound of head and neck | 3.6K | $209.5K | $58.80 | 2.44x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 741 | $198.3K | $267.58 | 1.93x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.0K | $175.3K | $86.97 | 2.19x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $150.2K | $112.11 | 1.79x |
| 31297 | Dilation of nasal sinus using an endoscope | 109 | $130.0K | $1.2K | 4.19x |
| 70486 | CT scan of face | 1.3K | $77.9K | $59.84 | 2.39x |
| 69210 | Removal of impact ear wax, one ear | 2.4K | $73.0K | $31.04 | 2.16x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 9.2K | $69.0K | $7.49 | 3.49x |
| 30117 | Removal or destruction of growth of nose through nose | 166 | $64.2K | $386.74 | 2.33x |
| 38724 | Removal of lymph nodes, muscle, and tissue of neck | 49 | $54.9K | $1.1K | 2.17x |
| 31257 | Complete examination of nose and sinuses and removal of nasal sinus using an endoscope | 87 | $41.4K | $476.42 | 3.15x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 337 | $36.4K | $108.03 | 1.50x |
This provider submits charges 2.14 times higher than what Medicare actually pays.
A markup ratio of 2.14x means for every $100 Medicare pays, this provider initially charges $214. 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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