This provider's $5.9M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 146% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 100% in 2019
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 | $1.2K | $358.11 | 3.48x | $889.48 | $465.7K | 2.1K | 1.6K |
| 2015 | $1.2K | $413.92 | 2.98x | $819.88 | $356.7K | 2.1K | 1.6K |
| 2016 | $1.5K | $428.00 | 3.57x | $1.1K | $358.5K | 2.2K | 1.5K |
| 2017 | $1.4K | $487.58 | 2.90x | $928.39 | $400.3K | 2.1K | 1.5K |
| 2018 | $1.2K | $483.34 | 2.51x | $727.91 | $395.5K | 2.7K | 2.0K |
| 2019 | $1.3K | $509.87 | 2.60x | $817.03 | $791.9K | 3.5K | 2.5K |
| 2020 | $2.1K | $632.22 | 3.29x | $1.4K | $589.5K | 2.6K | 1.8K |
| 2021 | $2.7K | $494.20 | 5.41x | $2.2K | $759.2K | 3.6K | 2.5K |
| 2022 | $2.7K | $503.17 | 5.36x | $2.2K | $616.5K | 3.8K | 2.7K |
| 2023 | $2.2K | $390.49 | 5.66x | $1.8K | $1.1M | 6.6K | 4.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 287 | $1.4M | $4.9K | 3.79x |
| 31295 | Dilation of nasal sinus using an endoscope | 508 | $960.9K | $1.9K | 4.41x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 3.8K | $522.8K | $136.07 | 2.76x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.8K | $495.1K | $178.11 | 3.08x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 4.6K | $450.3K | $97.25 | 2.54x |
| 31296 | Dilation of nasal sinus using an endoscope | 151 | $419.9K | $2.8K | 1.79x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 5.7K | $391.3K | $69.19 | 2.56x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 872 | $294.5K | $337.72 | 3.36x |
| 31297 | Dilation of nasal sinus using an endoscope | 145 | $207.6K | $1.4K | 3.46x |
| 69210 | Removal of impact ear wax, one ear | 5.0K | $192.3K | $38.59 | 3.73x |
| 92511 | Examination of the nose and throat using an endoscope | 1.8K | $188.4K | $105.97 | 4.02x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 841 | $71.3K | $84.81 | 3.07x |
| 70486 | Ct scan of face | 578 | $68.7K | $118.80 | 3.07x |
| 31238 | Control of nasal bleeding using an endoscope | 150 | $34.3K | $228.70 | 2.88x |
| 31276 | Exploration of nasal sinus using an endoscope | 35 | $16.6K | $475.06 | 4.98x |
| 30520 | Reshaping of nasal cartilage | 50 | $15.5K | $310.40 | 6.77x |
| 30117 | Removal or destruction of growth in nose, internal approach | 27 | $15.2K | $563.71 | 6.03x |
| 31254 | Partial removal of nasal sinus using an endoscope | 51 | $12.3K | $240.38 | 12.24x |
| 95117 | Injection of incremental dosages of allergen, 2 or more injections | 1.3K | $12.1K | $9.51 | 3.94x |
| 31267 | Removal of nasal sinus tissue using an endoscope, maxillary sinus | 43 | $11.3K | $262.72 | 6.85x |
This provider submits charges 3.46 times higher than what Medicare actually pays.
A markup ratio of 3.46x means for every $100 Medicare pays, this provider initially charges $346. 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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