This provider's $3.4M 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 | $408.57 | $95.57 | 4.28x | $313.00 | $381.9K | 3.3K | 2.7K |
| 2015 | $305.12 | $78.91 | 3.87x | $226.21 | $340.1K | 2.9K | 2.4K |
| 2016 | $315.47 | $75.40 | 4.18x | $240.07 | $353.9K | 3.5K | 2.9K |
| 2017 | $322.11 | $75.27 | 4.28x | $246.84 | $380.1K | 3.8K | 3.3K |
| 2018 | $322.22 | $75.20 | 4.28x | $247.02 | $364.1K | 3.7K | 3.1K |
| 2019 | $326.67 | $74.65 | 4.38x | $252.02 | $330.7K | 3.4K | 3.0K |
| 2020 | $322.22 | $76.25 | 4.23x | $245.97 | $238.1K | 2.6K | 2.3K |
| 2021 | $322.22 | $84.64 | 3.81x | $237.58 | $306.9K | 3.0K | 2.7K |
| 2022 | $322.22 | $82.04 | 3.93x | $240.18 | $329.5K | 3.2K | 2.8K |
| 2023 | $322.22 | $76.74 | 4.20x | $245.48 | $363.3K | 3.7K | 3.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 8.7K | $1.6M | $187.88 | 3.62x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 5.8K | $572.1K | $97.82 | 3.44x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 4.3K | $474.8K | $109.78 | 4.00x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.6K | $328.9K | $70.79 | 3.32x |
| 69210 | Removal of impact ear wax, one ear | 5.4K | $168.9K | $31.14 | 6.77x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 1.7K | $104.5K | $62.75 | 4.00x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.6K | $69.1K | $42.13 | 3.52x |
| 92504 | Diagnostic examination of ear and nose | 748 | $19.4K | $25.94 | 3.81x |
| 69200 | Removal of foreign body from ear canal | 171 | $12.4K | $72.60 | 6.02x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 34 | $9.9K | $289.92 | 6.70x |
| 10022 | Fine needle aspiration using imaging guidance | 14 | $1.7K | $118.12 | 3.87x |
| 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 14 | $412.30 | $29.45 | 4.17x |
This provider submits charges 3.8 times higher than what Medicare actually pays.
A markup ratio of 3.8x means for every $100 Medicare pays, this provider initially charges $380. 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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