This provider's $4.3M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 61% 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 | $462.67 | $237.63 | 1.95x | $225.04 | $349.1K | 4.9K | 4.3K |
| 2015 | $194.03 | $91.48 | 2.12x | $102.55 | $301.4K | 4.8K | 4.2K |
| 2016 | $210.47 | $104.28 | 2.02x | $106.19 | $332.4K | 5.1K | 4.5K |
| 2017 | $585.62 | $266.80 | 2.19x | $318.82 | $416.0K | 5.5K | 4.8K |
| 2018 | $466.11 | $225.13 | 2.07x | $240.98 | $358.1K | 4.9K | 4.3K |
| 2019 | $259.82 | $110.73 | 2.35x | $149.09 | $378.8K | 6.2K | 5.3K |
| 2020 | $188.71 | $92.12 | 2.05x | $96.59 | $466.2K | 8.0K | 6.8K |
| 2021 | $163.76 | $85.70 | 1.91x | $78.06 | $545.0K | 8.4K | 7.3K |
| 2022 | $194.65 | $96.61 | 2.01x | $98.04 | $562.0K | 8.6K | 7.3K |
| 2023 | $234.17 | $100.47 | 2.33x | $133.70 | $562.6K | 8.9K | 7.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 16.4K | $944.7K | $57.49 | 1.97x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 9.2K | $697.7K | $75.84 | 2.26x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 3.7K | $336.8K | $91.55 | 2.31x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 2.1K | $319.3K | $151.40 | 1.69x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 3.1K | $272.6K | $87.50 | 1.97x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 1.9K | $233.6K | $119.84 | 1.80x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 7.0K | $195.6K | $27.78 | 2.58x |
| 30903 | Complex control of nose bleed | 932 | $163.2K | $175.13 | 2.00x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 1.1K | $157.3K | $148.69 | 2.05x |
| 69210 | Removal of impact ear wax, one ear | 4.3K | $137.8K | $32.39 | 2.38x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 2.6K | $96.2K | $37.32 | 1.96x |
| 92550 | Assessment of eardrum and muscle function | 5.6K | $92.3K | $16.37 | 2.64x |
| 31296 | Dilation of nasal sinus using an endoscope | 38 | $88.9K | $2.3K | 1.36x |
| 69420 | Incision, aspiration, and/or inflation of eardrum | 353 | $53.7K | $152.21 | 1.96x |
| 30901 | Simple control of nose bleed | 514 | $53.0K | $103.07 | 2.07x |
| 92504 | Diagnostic examination of ear and nose | 2.3K | $49.5K | $21.44 | 2.23x |
| 31295 | Dilation of nasal sinus using an endoscope | 38 | $47.7K | $1.3K | 3.11x |
| 69433 | Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | 279 | $45.4K | $162.64 | 1.96x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 208 | $40.9K | $196.81 | 2.43x |
| 30906 | Control of nosebleed and insertion of packing | 148 | $39.2K | $265.06 | 1.63x |
This provider submits charges 2.09 times higher than what Medicare actually pays.
A markup ratio of 2.09x means for every $100 Medicare pays, this provider initially charges $209. 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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