This provider's $6.2M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 139% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 83% 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 | $2.0K | $373.93 | 5.45x | $1.7K | $544.3K | 2.5K | 2.0K |
| 2015 | $2.2K | $402.59 | 5.35x | $1.8K | $581.9K | 2.3K | 1.7K |
| 2016 | $1.9K | $290.70 | 6.49x | $1.6K | $491.5K | 2.2K | 1.7K |
| 2017 | $2.1K | $313.82 | 6.80x | $1.8K | $419.8K | 2.3K | 1.6K |
| 2018 | $1.8K | $473.87 | 3.75x | $1.3K | $446.8K | 2.3K | 1.7K |
| 2019 | $1.9K | $515.39 | 3.75x | $1.4K | $543.3K | 2.4K | 1.8K |
| 2020 | $2.1K | $594.12 | 3.61x | $1.6K | $502.3K | 2.0K | 1.6K |
| 2021 | $2.1K | $593.33 | 3.57x | $1.5K | $692.1K | 2.5K | 2.0K |
| 2022 | $2.2K | $555.09 | 3.99x | $1.7K | $711.4K | 2.5K | 2.0K |
| 2023 | $2.3K | $567.99 | 4.00x | $1.7K | $1.3M | 3.7K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31295 | Dilation of nasal sinus using an endoscope | 606 | $990.4K | $1.6K | 6.10x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 2.2K | $691.3K | $310.44 | 5.53x |
| 31296 | Dilation of nasal sinus using an endoscope | 347 | $663.9K | $1.9K | 5.12x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.9K | $635.7K | $163.33 | 2.60x |
| 31298 | Dilation of nasal sinus using an endoscope | 133 | $488.1K | $3.7K | 2.99x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 2.8K | $264.9K | $95.19 | 4.46x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 4.3K | $255.3K | $59.81 | 2.48x |
| 31297 | Dilation of nasal sinus using an endoscope | 199 | $247.6K | $1.2K | 7.88x |
| 30469 | Repair of collapsed nasal valve | 133 | $230.8K | $1.7K | 3.63x |
| 30468 | Repair of collapsed nostril using implant in side of nose | 99 | $221.1K | $2.2K | 2.92x |
| 41530 | Destruction of tongue tissue, per session | 69 | $187.1K | $2.7K | 2.03x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.8K | $149.9K | $82.20 | 3.02x |
| 70486 | CT scan of face | 1.8K | $140.5K | $77.02 | 7.37x |
| 91035 | Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis and interpretation | 282 | $113.1K | $400.96 | 2.43x |
| J3490 | Unclassified drugs | 84 | $103.9K | $1.2K | 2.35x |
| 30117 | Removal or destruction of growth of nose through nose | 241 | $103.8K | $430.66 | 4.16x |
| 31238 | Control of nasal bleeding using an endoscope | 382 | $81.6K | $213.68 | 4.72x |
| 43197 | Diagnostic examination of esophagus using an endoscope | 446 | $72.7K | $162.96 | 3.38x |
| 95827 | Measurement and recording of brain wave (EEG) activity, overnight | 140 | $71.0K | $507.11 | 4.34x |
| 30801 | Destruction of soft tissue of nasal passages | 449 | $62.1K | $138.22 | 4.70x |
This provider submits charges 4.42 times higher than what Medicare actually pays.
A markup ratio of 4.42x means for every $100 Medicare pays, this provider initially charges $442. 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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