This provider's $7.0M 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 | $207.21 | $90.89 | 2.28x | $116.32 | $838.4K | 9.8K | 6.6K |
| 2015 | $232.90 | $92.39 | 2.52x | $140.51 | $910.4K | 10.4K | 6.9K |
| 2016 | $240.43 | $99.23 | 2.42x | $141.20 | $775.9K | 10.0K | 6.4K |
| 2017 | $237.32 | $85.06 | 2.79x | $152.26 | $657.9K | 8.5K | 5.3K |
| 2018 | $233.87 | $85.12 | 2.75x | $148.75 | $672.4K | 8.6K | 5.3K |
| 2019 | $288.07 | $106.12 | 2.71x | $181.95 | $626.0K | 7.7K | 4.6K |
| 2020 | $288.62 | $105.89 | 2.73x | $182.73 | $598.3K | 7.3K | 4.5K |
| 2021 | $233.92 | $82.78 | 2.83x | $151.14 | $647.0K | 7.4K | 4.3K |
| 2022 | $212.98 | $78.37 | 2.72x | $134.61 | $655.2K | 7.6K | 4.6K |
| 2023 | $231.35 | $74.14 | 3.12x | $157.21 | $667.4K | 8.0K | 4.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 15.5K | $2.5M | $159.94 | 2.32x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 23.1K | $1.4M | $59.65 | 2.22x |
| 92511 | Examination of the nose and throat using an endoscope | 10.5K | $967.8K | $92.28 | 2.89x |
| 69210 | Removal of impact ear wax, one ear | 17.4K | $530.7K | $30.46 | 3.58x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.8K | $306.8K | $81.67 | 2.41x |
| 31233 | Examination of nasal passage and sinus using an endoscope | 1.2K | $284.6K | $242.62 | 2.13x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.2K | $174.8K | $80.14 | 2.63x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $162.0K | $125.77 | 2.35x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 563 | $150.7K | $267.63 | 2.33x |
| 31238 | Control of nasal bleeding using an endoscope | 525 | $111.4K | $212.27 | 3.01x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.2K | $104.5K | $85.29 | 2.21x |
| 99291 | Critical care delivery critically ill or injured patient, first 30-74 minutes | 339 | $61.9K | $182.45 | 2.61x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 360 | $58.6K | $162.89 | 2.18x |
| 92562 | Comparison assessment of hearing tones in one or both ears | 1.2K | $44.8K | $37.68 | 1.92x |
| 30117 | Removal or destruction of growth in nose | 40 | $24.9K | $623.53 | 2.75x |
| 92550 | Assessment of eardrum and muscle function | 1.3K | $22.4K | $17.56 | 2.16x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 712 | $21.9K | $30.82 | 2.33x |
| 92563 | Hearing test using earphones | 729 | $18.6K | $25.57 | 2.20x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 436 | $15.2K | $34.92 | 2.73x |
| 31615 | Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope | 110 | $11.6K | $105.62 | 3.03x |
This provider submits charges 2.49 times higher than what Medicare actually pays.
A markup ratio of 2.49x means for every $100 Medicare pays, this provider initially charges $249. 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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