This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 309% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 103% in 2021
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 | $1.4K | $363.33 | 3.87x | $1.0K | $226.8K | 2.4K | 1.5K |
| 2015 | $1.4K | $357.24 | 3.88x | $1.0K | $341.1K | 2.8K | 1.8K |
| 2016 | $1.4K | $378.28 | 3.78x | $1.1K | $294.9K | 2.8K | 1.9K |
| 2017 | $1.3K | $343.62 | 3.66x | $912.46 | $369.9K | 3.5K | 2.6K |
| 2018 | $1.2K | $390.64 | 3.04x | $797.20 | $418.0K | 3.9K | 2.9K |
| 2019 | $1.3K | $397.43 | 3.17x | $861.25 | $370.1K | 4.0K | 3.0K |
| 2020 | $798.29 | $260.55 | 3.06x | $537.74 | $276.9K | 3.6K | 2.6K |
| 2021 | $1.7K | $564.72 | 3.01x | $1.1K | $563.0K | 4.2K | 2.9K |
| 2022 | $2.0K | $640.20 | 3.09x | $1.3K | $593.0K | 4.3K | 3.1K |
| 2023 | $2.0K | $602.18 | 3.36x | $1.4K | $927.8K | 4.5K | 3.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.2K | $848.0K | $64.21 | 1.84x |
| 31298 | Dilation of nasal sinus using an endoscope | 166 | $780.6K | $4.7K | 2.92x |
| 31295 | Dilation of nasal sinus using an endoscope | 341 | $670.6K | $2.0K | 3.85x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 4.9K | $421.1K | $86.75 | 2.54x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 1.3K | $240.3K | $178.80 | 2.35x |
| 31296 | Dilation of nasal sinus using an endoscope | 78 | $206.0K | $2.6K | 2.95x |
| 92504 | Diagnostic examination of ear and nose | 6.8K | $173.1K | $25.30 | 2.77x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $171.2K | $133.79 | 2.45x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 1.6K | $156.9K | $99.80 | 1.76x |
| 99223 | Initial hospital inpatient care, typically 70 minutes per day | 721 | $121.9K | $169.03 | 2.46x |
| 30117 | Removal or destruction of growth in nose | 157 | $107.9K | $687.44 | 3.10x |
| 31297 | Dilation of nasal sinus using an endoscope | 71 | $95.6K | $1.3K | 5.65x |
| 69705 | Dilation of canal between middle ear and throat (eustachian tube) on one side of body, using endoscope inserted through nose | 30 | $79.5K | $2.7K | 2.74x |
| 31254 | Partial removal of nasal sinus using an endoscope | 195 | $59.9K | $307.22 | 4.94x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 806 | $48.4K | $60.10 | 2.54x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 454 | $40.8K | $89.89 | 1.74x |
| 92552 | Pure tone air conduction threshold hearing assessment | 1.1K | $34.0K | $29.86 | 2.48x |
| 30140 | Removal of nasal air passage | 136 | $29.6K | $217.56 | 6.84x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 64 | $19.8K | $308.87 | 3.35x |
| 69210 | Removal of impact ear wax, one ear | 415 | $15.0K | $36.19 | 2.62x |
This provider submits charges 2.82 times higher than what Medicare actually pays.
A markup ratio of 2.82x means for every $100 Medicare pays, this provider initially charges $282. 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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