This provider's $6.7M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $1.3K | $306.33 | 4.40x | $1.0K | $730.4K | 5.0K | 2.7K |
| 2015 | $1.4K | $343.58 | 4.04x | $1.0K | $584.5K | 4.7K | 2.7K |
| 2016 | $1.2K | $287.86 | 4.05x | $877.02 | $610.4K | 5.1K | 2.7K |
| 2017 | $1.3K | $270.18 | 4.79x | $1.0K | $682.7K | 5.2K | 2.7K |
| 2018 | $1.1K | $268.71 | 3.98x | $800.90 | $786.9K | 5.5K | 2.8K |
| 2019 | $1.3K | $442.81 | 2.86x | $824.12 | $907.5K | 5.5K | 3.0K |
| 2020 | $1.4K | $449.33 | 3.07x | $929.13 | $616.8K | 4.2K | 2.3K |
| 2021 | $869.02 | $264.50 | 3.29x | $604.52 | $570.7K | 4.7K | 2.5K |
| 2022 | $1.3K | $388.24 | 3.35x | $913.01 | $575.0K | 4.7K | 2.5K |
| 2023 | $1.1K | $324.70 | 3.47x | $803.41 | $644.4K | 5.0K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 9.6K | $1.6M | $161.62 | 1.55x |
| 31295 | Dilation of nasal sinus using an endoscope | 658 | $1.2M | $1.8K | 2.27x |
| 31296 | Dilation of nasal sinus using an endoscope | 285 | $684.9K | $2.4K | 2.73x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 12.1K | $677.3K | $55.83 | 1.61x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 1.7K | $450.5K | $258.58 | 1.96x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 3.3K | $379.7K | $113.55 | 1.45x |
| 31298 | Dilation of nasal sinus using an endoscope | 70 | $295.1K | $4.2K | 1.72x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.3K | $203.8K | $88.00 | 1.53x |
| 31225 | Removal of nasal sinus | 65 | $110.5K | $1.7K | 2.93x |
| 30520 | Reshaping of nasal cartilage | 294 | $101.1K | $343.98 | 7.56x |
| 69210 | Removal of impact ear wax, one ear | 3.1K | $97.2K | $31.18 | 2.57x |
| 30140 | Removal of nasal air passage | 375 | $95.8K | $255.44 | 7.30x |
| 99205 | New patient office or other outpatient visit, typically 60 minutes | 625 | $89.8K | $143.64 | 1.50x |
| 31297 | Dilation of nasal sinus using an endoscope | 61 | $82.4K | $1.4K | 5.06x |
| 92504 | Diagnostic examination of ear and nose | 3.4K | $81.2K | $23.57 | 2.12x |
| 31276 | Exploration of nasal sinus using an endoscope | 206 | $73.8K | $358.23 | 7.24x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 832 | $64.9K | $78.04 | 2.17x |
| 31267 | Removal of nasal sinus tissue using an endoscope | 295 | $55.1K | $186.69 | 11.86x |
| 31575 | Diagnostic examination of voice box using flexible endoscope | 734 | $52.6K | $71.62 | 4.89x |
| 96372 | Injection beneath the skin or into muscle for therapy, diagnosis, or prevention | 3.2K | $49.0K | $15.46 | 1.84x |
This provider submits charges 2.5 times higher than what Medicare actually pays.
A markup ratio of 2.5x means for every $100 Medicare pays, this provider initially charges $250. 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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