This provider's $5.4M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 741% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 332% in 2018
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 | $462.68 | $128.53 | 3.60x | $334.15 | $124.2K | 1.4K | 1.1K |
| 2015 | $313.78 | $87.20 | 3.60x | $226.58 | $93.6K | 1.4K | 969 |
| 2016 | $561.65 | $121.75 | 4.61x | $439.90 | $122.4K | 1.6K | 1.1K |
| 2017 | $348.72 | $102.92 | 3.39x | $245.80 | $125.4K | 1.8K | 1.4K |
| 2018 | $963.02 | $394.83 | 2.44x | $568.19 | $541.9K | 2.0K | 1.5K |
| 2019 | $1.0K | $403.13 | 2.56x | $629.02 | $893.7K | 2.1K | 1.8K |
| 2020 | $1.7K | $800.77 | 2.13x | $903.97 | $874.7K | 1.4K | 1.2K |
| 2021 | $1.5K | $693.25 | 2.14x | $787.08 | $892.3K | 1.4K | 1.2K |
| 2022 | $1.5K | $703.77 | 2.16x | $818.43 | $663.8K | 1.3K | 1.1K |
| 2023 | $2.1K | $755.32 | 2.71x | $1.3K | $1.0M | 1.4K | 1.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31298 | Dilation of nasal sinus using an endoscope | 639 | $2.6M | $4.1K | 2.05x |
| 31295 | Dilation of nasal sinus using an endoscope | 640 | $1.1M | $1.7K | 2.23x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.3K | $393.5K | $299.48 | 1.85x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 1.7K | $262.9K | $151.90 | 2.60x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 3.8K | $211.5K | $56.13 | 2.02x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 2.1K | $164.7K | $77.92 | 2.38x |
| 30117 | Removal or destruction of growth in nose | 370 | $132.2K | $357.28 | 3.37x |
| 30140 | Removal of nasal air passage | 653 | $117.3K | $179.57 | 5.04x |
| 69706 | Dilation of canal between middle ear and throat (eustachian tube) on both sides of body, using endoscope inserted through nose | 28 | $59.9K | $2.1K | 2.35x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 386 | $48.1K | $124.67 | 1.45x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 472 | $41.7K | $88.25 | 4.25x |
| 70486 | CT scan of face | 320 | $33.7K | $105.30 | 3.32x |
| 69210 | Removal of impact ear wax, one ear | 787 | $28.4K | $36.04 | 2.22x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 315 | $25.1K | $79.84 | 1.67x |
| 30520 | Reshaping of nasal cartilage | 87 | $24.1K | $277.07 | 6.78x |
| 31255 | Removal of nasal sinus using an endoscope | 99 | $18.5K | $186.41 | 5.78x |
| 99236 | Hospital observation or inpatient care high severity, 55 minutes per day | 99 | $16.8K | $170.20 | 2.94x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 553 | $15.5K | $27.98 | 4.82x |
| 99212 | Established patient outpatient visit, total time 10-19 minutes | 307 | $13.9K | $45.15 | 2.06x |
| 92540 | Observation, testing, and recording of abnormal eye movement | 158 | $12.1K | $76.76 | 2.61x |
This provider submits charges 2.29 times higher than what Medicare actually pays.
A markup ratio of 2.29x means for every $100 Medicare pays, this provider initially charges $229. 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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