This provider's $13.0M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Their average markup ratio of 6.1x is significantly above the specialty median of 3.3x.
Medicare payments to this provider grew 191% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 100% in 2018
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 | $1.5K | $275.71 | 5.60x | $1.3K | $671.0K | 1.9K | 1.5K |
| 2015 | $1.9K | $306.36 | 6.27x | $1.6K | $810.6K | 2.2K | 1.8K |
| 2016 | $2.0K | $293.92 | 6.83x | $1.7K | $931.0K | 2.3K | 2.1K |
| 2017 | $2.0K | $271.14 | 7.42x | $1.7K | $805.4K | 2.4K | 1.9K |
| 2018 | $2.5K | $375.42 | 6.66x | $2.1K | $1.6M | 2.9K | 2.6K |
| 2019 | $2.5K | $357.44 | 7.07x | $2.2K | $1.4M | 2.8K | 2.5K |
| 2020 | $3.0K | $454.25 | 6.61x | $2.5K | $1.3M | 2.2K | 1.9K |
| 2021 | $2.6K | $531.36 | 4.92x | $2.1K | $1.5M | 2.3K | 2.1K |
| 2022 | $3.4K | $655.40 | 5.15x | $2.7K | $2.0M | 2.2K | 2.0K |
| 2023 | $3.6K | $657.38 | 5.51x | $3.0K | $2.0M | 2.1K | 1.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 938 | $4.2M | $4.5K | 6.69x |
| 31295 | Dilation of nasal sinus using an endoscope | 1.4K | $2.2M | $1.5K | 7.58x |
| J3490 | Unclassified drugs | 291 | $1.6M | $5.5K | 3.12x |
| 31296 | Dilation of nasal sinus using an endoscope | 494 | $1.2M | $2.4K | 4.52x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 2.4K | $739.7K | $314.35 | 4.87x |
| 31297 | Dilation of nasal sinus using an endoscope | 501 | $601.2K | $1.2K | 9.10x |
| 30140 | Removal of nasal air passage | 1.4K | $297.5K | $207.20 | 12.26x |
| 30468 | Repair of collapsed nostril using implant in side of nose | 232 | $268.0K | $1.2K | 2.61x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 1.6K | $259.0K | $161.48 | 3.92x |
| 31254 | Partial removal of nasal sinus using an endoscope | 896 | $242.4K | $270.51 | 8.41x |
| 30117 | Removal or destruction of growth in nose | 524 | $212.8K | $406.13 | 6.32x |
| 77011 | CT scan guidance for stereotactic localization | 1.1K | $209.3K | $182.32 | 4.48x |
| 30520 | Reshaping of nasal cartilage | 698 | $183.7K | $263.25 | 10.64x |
| 61782 | Computer-assisted procedure outside the brain | 1.2K | $172.4K | $143.55 | 4.53x |
| 70486 | CT scan of face | 1.2K | $129.2K | $107.79 | 4.64x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 1.7K | $93.2K | $54.76 | 3.24x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 806 | $92.8K | $115.14 | 3.29x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $78.1K | $73.97 | 3.70x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 582 | $43.4K | $74.55 | 3.09x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 383 | $33.2K | $86.72 | 3.82x |
This provider submits charges 6.1 times higher than what Medicare actually pays.
A markup ratio of 6.1x means for every $100 Medicare pays, this provider initially charges $610. 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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