This provider's $4.9M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 159% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 311% 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 | $137.72 | $77.62 | 1.77x | $60.10 | $159.7K | 2.6K | 2.0K |
| 2015 | $1.6K | $353.18 | 4.46x | $1.2K | $656.4K | 5.1K | 2.8K |
| 2016 | $1.7K | $358.44 | 4.78x | $1.4K | $637.9K | 5.2K | 2.8K |
| 2017 | $2.0K | $416.44 | 4.72x | $1.5K | $674.0K | 5.3K | 2.8K |
| 2018 | $2.0K | $476.85 | 4.30x | $1.6K | $616.7K | 5.1K | 2.8K |
| 2019 | $1.8K | $475.08 | 3.85x | $1.4K | $538.3K | 5.2K | 3.0K |
| 2020 | $359.54 | $114.74 | 3.13x | $244.80 | $340.0K | 4.0K | 2.5K |
| 2021 | $208.68 | $106.38 | 1.96x | $102.30 | $399.1K | 4.1K | 2.5K |
| 2022 | $212.83 | $97.15 | 2.19x | $115.68 | $415.1K | 4.5K | 2.7K |
| 2023 | $208.19 | $95.95 | 2.17x | $112.24 | $413.4K | 4.5K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 17.6K | $1.4M | $81.08 | 1.76x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 7.3K | $1.1M | $152.60 | 1.64x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 5.9K | $524.4K | $88.66 | 2.51x |
| 31296 | Dilation of nasal sinus using an endoscope | 125 | $290.3K | $2.3K | 4.24x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.4K | $236.8K | $69.38 | 1.91x |
| 69210 | Removal of impact ear wax, one ear | 6.3K | $202.8K | $32.14 | 2.16x |
| 31298 | Dilation of nasal sinus using an endoscope | 45 | $194.5K | $4.3K | 3.93x |
| 31295 | Dilation of nasal sinus using an endoscope | 171 | $194.4K | $1.1K | 5.23x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 664 | $194.4K | $292.71 | 2.81x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.3K | $148.5K | $118.24 | 1.82x |
| 31297 | Dilation of nasal sinus using an endoscope | 125 | $144.2K | $1.2K | 7.74x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.2K | $51.0K | $43.22 | 1.63x |
| 31238 | Control of nasal bleeding using an endoscope | 230 | $46.2K | $200.67 | 2.20x |
| 92511 | Examination of the nose and throat using an endoscope | 446 | $38.8K | $86.94 | 2.31x |
| 30140 | Removal of nasal air passage | 28 | $7.7K | $275.00 | 7.69x |
| 21335 | Open treatment of broken nasal bone and nasal cartilage | 12 | $6.9K | $578.96 | 5.18x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 140 | $5.2K | $37.30 | 1.88x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 45 | $4.7K | $105.13 | 1.81x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 125 | $3.8K | $30.45 | 1.57x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 17 | $2.9K | $171.11 | 3.44x |
This provider submits charges 2.46 times higher than what Medicare actually pays.
A markup ratio of 2.46x means for every $100 Medicare pays, this provider initially charges $246. 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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