This provider's $4.7M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 81% 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 | $481.17 | $140.29 | 3.43x | $340.88 | $386.6K | 4.6K | 3.3K |
| 2015 | $430.22 | $134.78 | 3.19x | $295.44 | $320.3K | 3.9K | 2.9K |
| 2016 | $464.78 | $136.32 | 3.41x | $328.46 | $366.6K | 4.4K | 3.2K |
| 2017 | $489.36 | $136.19 | 3.59x | $353.17 | $360.2K | 4.7K | 3.3K |
| 2018 | $543.47 | $149.01 | 3.65x | $394.46 | $385.8K | 4.7K | 3.2K |
| 2019 | $560.80 | $152.09 | 3.69x | $408.71 | $409.3K | 4.6K | 3.5K |
| 2020 | $479.94 | $142.51 | 3.37x | $337.43 | $504.7K | 6.1K | 4.7K |
| 2021 | $431.53 | $128.06 | 3.37x | $303.47 | $617.7K | 7.5K | 5.7K |
| 2022 | $519.83 | $149.92 | 3.47x | $369.91 | $671.4K | 8.0K | 6.1K |
| 2023 | $583.75 | $171.26 | 3.41x | $412.49 | $701.4K | 8.5K | 6.5K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 6.5K | $988.8K | $151.65 | 2.45x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 10.0K | $575.3K | $57.28 | 2.86x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.2K | $483.4K | $115.79 | 2.90x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 5.6K | $483.4K | $86.27 | 3.00x |
| 69210 | Removal of impact ear wax, one ear | 12.0K | $377.5K | $31.37 | 3.25x |
| 92511 | Examination of the nose and throat using an endoscope | 3.4K | $294.7K | $86.54 | 3.37x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.9K | $286.1K | $98.22 | 3.02x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 3.6K | $264.2K | $74.29 | 2.94x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 702 | $194.0K | $276.39 | 3.23x |
| 30520 | Reshaping of nasal cartilage | 324 | $127.4K | $393.29 | 3.21x |
| 30130 | Removal of nasal air passage | 396 | $112.3K | $283.48 | 4.79x |
| 31253 | Complete examination of nose and sinuses using an endoscope | 114 | $62.8K | $550.84 | 3.68x |
| 69436 | Incision of eardrum with insertion of eardrum tube under general anesthesia | 422 | $60.4K | $143.24 | 3.51x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 1.6K | $56.1K | $34.52 | 3.20x |
| 30117 | Removal or destruction of growth in nose | 86 | $52.2K | $607.13 | 3.31x |
| 31276 | Exploration of nasal sinus using an endoscope | 80 | $44.4K | $555.04 | 3.15x |
| 69220 | Removal of skin debris and drainage of mastoid cavity | 637 | $41.8K | $65.60 | 3.34x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 209 | $35.7K | $170.82 | 2.76x |
| 31238 | Control of nasal bleeding using an endoscope | 182 | $29.8K | $163.52 | 3.40x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 140 | $27.0K | $192.65 | 4.57x |
This provider submits charges 3.01 times higher than what Medicare actually pays.
A markup ratio of 3.01x means for every $100 Medicare pays, this provider initially charges $301. 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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