This provider's $4.1M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
66% of their billing comes from a single procedure code (31231 — Diagnostic examination of nasal passages using an endoscope).
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 | $1.5K | $211.13 | 6.93x | $1.3K | $419.2K | 3.0K | 1.3K |
| 2015 | $1.5K | $194.00 | 7.60x | $1.3K | $457.3K | 3.0K | 1.3K |
| 2016 | $1.2K | $209.29 | 5.74x | $992.69 | $461.1K | 3.3K | 1.3K |
| 2017 | $683.78 | $159.07 | 4.30x | $524.71 | $425.6K | 3.2K | 1.2K |
| 2018 | $679.02 | $154.85 | 4.39x | $524.17 | $423.3K | 3.2K | 1.2K |
| 2019 | $665.57 | $156.84 | 4.24x | $508.73 | $435.8K | 3.3K | 1.3K |
| 2020 | $702.99 | $162.46 | 4.33x | $540.53 | $294.4K | 2.3K | 1.1K |
| 2021 | $725.76 | $168.95 | 4.30x | $556.81 | $368.8K | 2.6K | 1.2K |
| 2022 | $660.35 | $152.62 | 4.33x | $507.73 | $402.5K | 3.0K | 1.4K |
| 2023 | $585.92 | $133.51 | 4.39x | $452.41 | $432.7K | 3.2K | 1.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 14.1K | $2.7M | $191.96 | 3.06x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.1K | $844.5K | $69.93 | 3.50x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 1.3K | $134.6K | $107.15 | 3.62x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 438 | $125.5K | $286.60 | 4.63x |
| 70486 | CT scan of face | 871 | $116.4K | $133.59 | 5.60x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 805 | $76.8K | $95.41 | 3.28x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 277 | $39.7K | $143.38 | 4.02x |
| 31276 | Exploration of nasal sinus using an endoscope | 58 | $33.5K | $577.61 | 7.15x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 122 | $27.0K | $221.40 | 7.70x |
| 31255 | Removal of nasal sinus using an endoscope | 27 | $6.3K | $233.50 | 14.32x |
| 77011 | Ct scan guidance for stereotactic localization | 14 | $3.3K | $235.88 | 4.24x |
| 61782 | Computer-assisted procedure outside the brain | 13 | $2.0K | $155.70 | 5.46x |
| 31254 | Partial removal of nasal sinus using an endoscope | 12 | $1.6K | $137.25 | 13.21x |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 16 | $551.30 | $34.46 | 5.80x |
This provider submits charges 3.39 times higher than what Medicare actually pays.
A markup ratio of 3.39x means for every $100 Medicare pays, this provider initially charges $339. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data