This provider's $4.4M 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 | $2.3K | $329.86 | 6.86x | $1.9K | $359.1K | 2.9K | 2.0K |
| 2015 | $2.3K | $314.51 | 7.28x | $2.0K | $384.3K | 3.0K | 2.0K |
| 2016 | $2.1K | $304.88 | 6.87x | $1.8K | $420.1K | 4.1K | 2.5K |
| 2017 | $2.1K | $293.04 | 7.12x | $1.8K | $406.9K | 4.4K | 2.4K |
| 2018 | $2.1K | $340.78 | 6.25x | $1.8K | $412.4K | 4.5K | 2.3K |
| 2019 | $2.5K | $388.67 | 6.48x | $2.1K | $460.9K | 3.9K | 2.6K |
| 2020 | $2.8K | $475.38 | 5.83x | $2.3K | $496.4K | 4.5K | 3.2K |
| 2021 | $2.5K | $492.11 | 5.01x | $2.0K | $500.6K | 4.3K | 3.1K |
| 2022 | $1.1K | $230.43 | 4.72x | $856.38 | $449.5K | 5.0K | 3.7K |
| 2023 | $1.2K | $244.26 | 4.84x | $938.00 | $508.5K | 6.0K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 7.0K | $965.7K | $138.82 | 2.88x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 8.5K | $712.1K | $83.34 | 2.94x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.1K | $395.4K | $55.87 | 2.77x |
| 31296 | Dilation of nasal sinus using an endoscope | 173 | $370.4K | $2.1K | 6.26x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 4.6K | $342.2K | $74.87 | 3.82x |
| 31295 | Dilation of nasal sinus using an endoscope | 248 | $332.8K | $1.3K | 5.31x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 852 | $235.2K | $276.10 | 4.72x |
| 31298 | Dilation of nasal sinus using an endoscope | 49 | $197.7K | $4.0K | 5.19x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.1K | $174.2K | $82.74 | 3.93x |
| 69210 | Removal of impact ear wax, one ear | 5.2K | $157.1K | $30.20 | 2.49x |
| 30520 | Reshaping of nasal cartilage | 191 | $57.5K | $301.00 | 8.17x |
| 31297 | Dilation of nasal sinus using an endoscope | 54 | $57.1K | $1.1K | 11.08x |
| 30140 | Removal of nasal air passage | 275 | $54.4K | $197.83 | 11.56x |
| 31276 | Exploration of nasal sinus using an endoscope | 122 | $51.7K | $423.76 | 6.78x |
| 31238 | Control of nasal bleeding using an endoscope | 210 | $37.5K | $178.75 | 6.18x |
| 31254 | Partial removal of nasal sinus using an endoscope | 162 | $33.7K | $207.89 | 9.12x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 281 | $29.4K | $104.72 | 3.34x |
| 69706 | Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose | 11 | $23.2K | $2.1K | 4.39x |
| 30117 | Removal or destruction of growth in nose | 40 | $22.0K | $549.15 | 5.17x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 127 | $21.7K | $171.25 | 11.58x |
This provider submits charges 4.2 times higher than what Medicare actually pays.
A markup ratio of 4.2x means for every $100 Medicare pays, this provider initially charges $420. 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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