This provider's $3.7M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Their average markup ratio of 5.37x is significantly above the specialty median of 3.3x.
Medicare payments to this provider grew 321% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 107% in 2023
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 | $685.99 | $148.53 | 4.62x | $537.46 | $211.8K | 2.6K | 1.9K |
| 2015 | $570.05 | $116.96 | 4.87x | $453.09 | $192.5K | 2.5K | 1.9K |
| 2016 | $502.26 | $103.76 | 4.84x | $398.50 | $180.1K | 2.4K | 1.8K |
| 2017 | $694.62 | $137.60 | 5.05x | $557.02 | $199.7K | 2.4K | 1.8K |
| 2018 | $2.1K | $410.24 | 5.08x | $1.7K | $251.9K | 2.2K | 1.7K |
| 2019 | $2.9K | $465.41 | 6.31x | $2.5K | $454.4K | 1.8K | 1.5K |
| 2020 | $3.1K | $529.70 | 5.80x | $2.5K | $443.0K | 1.5K | 1.2K |
| 2021 | $4.1K | $711.71 | 5.76x | $3.4K | $436.5K | 1.2K | 999 |
| 2022 | $4.1K | $657.89 | 6.24x | $3.4K | $431.6K | 1.3K | 1.1K |
| 2023 | $3.6K | $632.05 | 5.67x | $3.0K | $891.8K | 1.9K | 1.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 295 | $1.3M | $4.3K | 5.68x |
| 31295 | Dilation of nasal sinus using an endoscope | 280 | $508.6K | $1.8K | 7.17x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.5K | $407.1K | $162.71 | 3.82x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.7K | $264.2K | $56.39 | 4.01x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 767 | $242.4K | $316.06 | 6.08x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.8K | $219.5K | $77.52 | 4.41x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.3K | $210.0K | $93.27 | 4.07x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.2K | $144.1K | $124.52 | 4.22x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.0K | $96.2K | $92.23 | 3.63x |
| 69706 | Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose | 34 | $75.0K | $2.2K | 4.53x |
| 30140 | Removal of nasal air passage | 282 | $53.8K | $190.65 | 14.89x |
| 69210 | Removal of impact ear wax, one ear | 1.4K | $48.1K | $35.57 | 4.67x |
| 30469 | Repair of collapsed nasal valve | 12 | $24.7K | $2.1K | 3.77x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 727 | $22.4K | $30.87 | 4.42x |
| 31255 | Removal of nasal sinus using an endoscope | 61 | $18.3K | $299.28 | 6.59x |
| 31276 | Exploration of nasal sinus using an endoscope | 27 | $17.0K | $628.34 | 4.09x |
| 61782 | Computer-assisted procedure outside the brain | 93 | $14.7K | $157.94 | 4.67x |
| 92504 | Diagnostic examination of ear and nose | 590 | $13.3K | $22.48 | 4.35x |
| 99202 | New patient office or other outpatient visit, typically 20 minutes | 204 | $10.1K | $49.64 | 4.69x |
| 95992 | Repositioning maneuvers for treatment of vertigo, per day | 291 | $9.8K | $33.55 | 4.15x |
This provider submits charges 5.37 times higher than what Medicare actually pays.
A markup ratio of 5.37x means for every $100 Medicare pays, this provider initially charges $537. 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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