This provider's $4.0M 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 | $321.05 | $109.50 | 2.93x | $211.55 | $393.8K | 3.8K | 2.4K |
| 2015 | $755.56 | $137.40 | 5.50x | $618.16 | $416.8K | 4.0K | 2.5K |
| 2016 | $313.30 | $119.97 | 2.61x | $193.33 | $419.0K | 4.0K | 2.4K |
| 2017 | $659.47 | $122.47 | 5.38x | $537.00 | $380.3K | 3.9K | 2.5K |
| 2018 | $322.36 | $106.40 | 3.03x | $215.96 | $373.5K | 3.8K | 2.5K |
| 2019 | $327.94 | $111.74 | 2.93x | $216.20 | $408.0K | 4.0K | 2.5K |
| 2020 | $287.44 | $106.19 | 2.71x | $181.25 | $349.6K | 3.7K | 2.4K |
| 2021 | $321.93 | $124.28 | 2.59x | $197.65 | $403.1K | 3.7K | 2.3K |
| 2022 | $277.65 | $116.73 | 2.38x | $160.92 | $418.2K | 4.0K | 2.4K |
| 2023 | $290.94 | $120.29 | 2.42x | $170.65 | $453.4K | 4.5K | 2.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 12.1K | $2.0M | $166.59 | 1.99x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.9K | $342.5K | $70.52 | 1.68x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 3.1K | $285.5K | $90.98 | 2.75x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 7.6K | $278.0K | $36.66 | 2.52x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $252.1K | $133.57 | 1.65x |
| 69222 | Removal of skin debris and drainage of mastoid cavity | 580 | $132.3K | $228.02 | 1.89x |
| 31615 | Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope | 1.0K | $118.0K | $116.53 | 3.86x |
| 99222 | Initial hospital inpatient care, typically 50 minutes per day | 883 | $100.1K | $113.36 | 2.95x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 326 | $95.4K | $292.53 | 2.56x |
| 69210 | Removal of impact ear wax, one ear | 3.4K | $79.5K | $23.20 | 3.23x |
| 31238 | Control of nasal bleeding using an endoscope | 288 | $61.0K | $211.83 | 2.45x |
| 99232 | Subsequent hospital inpatient care, typically 25 minutes per day | 736 | $43.9K | $59.59 | 2.73x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 237 | $39.7K | $167.51 | 2.09x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 370 | $32.3K | $87.24 | 1.75x |
| 31525 | Diagnostic examination of voice box using an endoscope | 210 | $27.8K | $132.59 | 3.77x |
| 43200 | Diagnostic examination of esophagus using an endoscope | 120 | $26.0K | $216.70 | 3.69x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 189 | $19.5K | $103.38 | 1.65x |
| 31600 | Opening of windpipe through neck for insertion of breathing tube | 53 | $16.1K | $304.68 | 3.62x |
| 92504 | Diagnostic examination of ear and nose | 607 | $15.1K | $24.88 | 2.21x |
| 30140 | Removal of nasal air passage | 24 | $9.8K | $408.75 | 5.50x |
This provider submits charges 2.26 times higher than what Medicare actually pays.
A markup ratio of 2.26x means for every $100 Medicare pays, this provider initially charges $226. 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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