This provider's $3.7M 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 | $609.40 | $231.18 | 2.64x | $378.22 | $445.3K | 5.0K | 4.0K |
| 2015 | $549.46 | $223.72 | 2.46x | $325.74 | $448.1K | 4.9K | 3.8K |
| 2016 | $634.82 | $257.57 | 2.46x | $377.25 | $419.1K | 4.6K | 3.5K |
| 2017 | $259.42 | $92.35 | 2.81x | $167.07 | $358.2K | 3.9K | 2.8K |
| 2018 | $233.10 | $93.21 | 2.50x | $139.89 | $362.8K | 3.9K | 2.8K |
| 2019 | $233.47 | $91.76 | 2.54x | $141.71 | $328.1K | 3.7K | 2.7K |
| 2020 | $227.52 | $88.18 | 2.58x | $139.34 | $277.3K | 3.2K | 2.3K |
| 2021 | $199.10 | $83.06 | 2.40x | $116.04 | $318.9K | 3.4K | 2.4K |
| 2022 | $297.67 | $98.41 | 3.02x | $199.26 | $324.3K | 3.3K | 2.5K |
| 2023 | $256.41 | $81.50 | 3.15x | $174.91 | $376.5K | 4.0K | 3.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 12.8K | $1.9M | $146.59 | 2.02x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.6K | $601.1K | $56.86 | 2.64x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.6K | $221.5K | $84.19 | 2.35x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.5K | $191.4K | $77.98 | 2.36x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 538 | $150.5K | $279.82 | 3.29x |
| 31296 | Dilation of nasal sinus using an endoscope | 44 | $102.8K | $2.3K | 1.79x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 820 | $100.8K | $122.89 | 2.25x |
| 69210 | Removal of impact ear wax, one ear | 3.4K | $74.3K | $21.97 | 3.72x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 809 | $65.6K | $81.03 | 2.78x |
| 31295 | Dilation of nasal sinus using an endoscope | 44 | $54.8K | $1.2K | 3.36x |
| 31238 | Control of nasal bleeding using an endoscope | 259 | $50.2K | $193.88 | 3.80x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.6K | $44.7K | $27.54 | 4.25x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 1.1K | $28.2K | $25.14 | 2.81x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 171 | $18.4K | $107.58 | 1.50x |
| 92567 | Eardrum testing using ear probe | 1.7K | $18.0K | $10.84 | 4.59x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 162 | $12.6K | $78.06 | 3.35x |
| 92585 | Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system | 117 | $11.6K | $98.73 | 2.84x |
| 92584 | Testing of nerve from ear to brain (cochlear) | 167 | $10.3K | $61.48 | 4.15x |
| 30802 | Destruction of soft tissue in nasal passages | 40 | $4.6K | $114.54 | 2.48x |
| 92546 | Test for abnormal eye movement using a rotating chair | 39 | $3.7K | $95.52 | 2.98x |
This provider submits charges 2.37 times higher than what Medicare actually pays.
A markup ratio of 2.37x means for every $100 Medicare pays, this provider initially charges $237. 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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