This provider's $3.4M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 1560% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 312% in 2015
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 | $218.51 | $62.91 | 3.47x | $155.60 | $34.4K | 553 | 463 |
| 2015 | $237.63 | $80.11 | 2.97x | $157.52 | $141.8K | 2.2K | 1.8K |
| 2016 | $1.7K | $421.99 | 3.97x | $1.3K | $332.2K | 3.3K | 2.6K |
| 2017 | $1.6K | $392.59 | 4.16x | $1.2K | $351.7K | 3.1K | 2.5K |
| 2018 | $1.4K | $458.88 | 3.08x | $955.43 | $396.9K | 3.2K | 2.6K |
| 2019 | $1.6K | $512.68 | 3.02x | $1.0K | $354.3K | 3.9K | 3.0K |
| 2020 | $1.6K | $569.85 | 2.72x | $980.27 | $346.1K | 3.3K | 2.7K |
| 2021 | $1.5K | $561.83 | 2.68x | $944.17 | $462.1K | 4.2K | 3.4K |
| 2022 | $1.2K | $464.35 | 2.64x | $762.19 | $364.0K | 4.3K | 3.5K |
| 2023 | $1.8K | $507.03 | 3.54x | $1.3K | $571.0K | 5.5K | 4.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 117 | $573.6K | $4.9K | 2.22x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 7.9K | $511.9K | $65.06 | 3.10x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.9K | $373.6K | $96.39 | 2.64x |
| 69210 | Removal of impact ear wax, one ear | 8.9K | $340.2K | $38.41 | 2.61x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.2K | $274.7K | $87.18 | 2.88x |
| 31295 | Dilation of nasal sinus using an endoscope | 147 | $258.3K | $1.8K | 4.55x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.7K | $223.2K | $132.17 | 2.40x |
| 31233 | Examination of nasal passage and sinus using an endoscope | 466 | $156.1K | $335.08 | 2.10x |
| 31296 | Dilation of nasal sinus using an endoscope | 44 | $122.4K | $2.8K | 2.88x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 629 | $111.9K | $177.95 | 3.02x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 1.0K | $106.7K | $106.43 | 2.78x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.7K | $54.8K | $32.06 | 3.02x |
| 31297 | Dilation of nasal sinus using an endoscope | 40 | $54.8K | $1.4K | 5.48x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 1.6K | $44.6K | $28.56 | 4.35x |
| 92570 | Detection of middle ear fluid with assessment of eardrum and muscle function | 1.5K | $42.6K | $27.74 | 2.52x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 224 | $36.7K | $164.05 | 3.05x |
| 30140 | Removal of nasal air passage | 141 | $31.5K | $223.41 | 8.62x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 50 | $16.3K | $325.00 | 2.47x |
| 69200 | Removal of foreign body from ear canal | 102 | $7.6K | $74.31 | 4.79x |
| 30901 | Simple control of nose bleed | 43 | $4.5K | $105.18 | 2.78x |
This provider submits charges 2.94 times higher than what Medicare actually pays.
A markup ratio of 2.94x means for every $100 Medicare pays, this provider initially charges $294. 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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