This provider's $4.2M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 78% from 2014 to 2023.
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 | $202.90 | $93.51 | 2.17x | $109.39 | $299.7K | 3.8K | 2.9K |
| 2015 | $207.23 | $86.71 | 2.39x | $120.52 | $331.8K | 4.1K | 3.2K |
| 2016 | $209.41 | $93.73 | 2.23x | $115.68 | $317.0K | 4.0K | 3.1K |
| 2017 | $190.64 | $82.20 | 2.32x | $108.44 | $332.4K | 4.2K | 3.1K |
| 2018 | $195.92 | $80.99 | 2.42x | $114.93 | $364.8K | 4.5K | 3.5K |
| 2019 | $297.30 | $102.50 | 2.90x | $194.80 | $400.2K | 4.6K | 3.6K |
| 2020 | $265.18 | $117.80 | 2.25x | $147.38 | $453.7K | 5.1K | 3.7K |
| 2021 | $950.42 | $447.39 | 2.12x | $503.03 | $666.2K | 5.4K | 3.7K |
| 2022 | $944.71 | $420.57 | 2.25x | $524.14 | $550.3K | 4.4K | 3.2K |
| 2023 | $1.1K | $408.68 | 2.64x | $670.51 | $533.7K | 3.7K | 2.7K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 9.1K | $1.5M | $165.97 | 2.30x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.2K | $705.9K | $57.88 | 2.06x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 4.8K | $427.1K | $88.68 | 2.20x |
| 31298 | Dilation of sphenoid and frontal sinus in the nose using an endoscope | 57 | $261.2K | $4.6K | 2.15x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 1.3K | $170.7K | $133.27 | 1.57x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 928 | $145.0K | $156.28 | 2.27x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 898 | $144.0K | $160.41 | 1.83x |
| 31295 | Dilation of maxillary sinus in the nose using an endoscope | 59 | $127.7K | $2.2K | 2.37x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.6K | $121.8K | $78.15 | 2.29x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.0K | $84.2K | $82.32 | 1.90x |
| 92546 | Assessment and recording of abnormal eye movement with patient in a rotating chair | 836 | $79.1K | $94.65 | 1.93x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 2.6K | $69.2K | $26.14 | 5.62x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 2.3K | $64.9K | $28.70 | 3.20x |
| 92570 | Detection of middle ear fluid with assessment of eardrum and muscle function | 2.6K | $64.2K | $24.63 | 1.94x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 762 | $64.1K | $84.18 | 1.74x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 170 | $48.7K | $286.51 | 1.94x |
| 30469 | Repair of collapsed nasal valve | 24 | $29.7K | $1.2K | 3.68x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 236 | $29.3K | $124.31 | 2.00x |
| 92537 | Assessment and recording of balance system during hot and cold irrigation of both ears | 659 | $21.6K | $32.77 | 2.08x |
| 30117 | Removal or destruction of growth in nose | 37 | $17.5K | $473.90 | 3.63x |
This provider submits charges 2.27 times higher than what Medicare actually pays.
A markup ratio of 2.27x means for every $100 Medicare pays, this provider initially charges $227. 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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