This provider's $4.5M 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 | $112.09 | $78.83 | 1.42x | $33.26 | $510.1K | 7.7K | 4.8K |
| 2015 | $118.88 | $84.77 | 1.40x | $34.11 | $512.0K | 7.7K | 4.6K |
| 2016 | $109.56 | $75.88 | 1.44x | $33.68 | $488.1K | 7.5K | 4.5K |
| 2017 | $104.18 | $68.98 | 1.51x | $35.20 | $388.2K | 6.4K | 4.0K |
| 2018 | $102.97 | $68.73 | 1.50x | $34.24 | $479.5K | 7.4K | 4.4K |
| 2019 | $115.28 | $66.45 | 1.73x | $48.83 | $507.9K | 7.6K | 4.8K |
| 2020 | $137.04 | $73.37 | 1.87x | $63.67 | $360.8K | 5.3K | 3.4K |
| 2021 | $148.81 | $82.02 | 1.81x | $66.79 | $421.6K | 5.8K | 3.7K |
| 2022 | $152.88 | $78.72 | 1.94x | $74.16 | $435.3K | 6.0K | 3.8K |
| 2023 | $163.71 | $83.17 | 1.97x | $80.54 | $430.0K | 6.5K | 4.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31575 | Diagnostic examination of voice box using flexible endoscope | 14.5K | $1.4M | $92.84 | 1.84x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 19.4K | $1.1M | $57.57 | 1.50x |
| 31231 | Diagnostic examination of nasal passages using an endoscope | 3.6K | $591.6K | $162.63 | 1.54x |
| 31238 | Control of nasal bleeding using an endoscope | 2.3K | $498.1K | $219.80 | 1.38x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 2.6K | $210.2K | $80.12 | 1.49x |
| G0268 | Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing | 7.4K | $165.2K | $22.33 | 3.14x |
| 69210 | Removal of impact ear wax, one ear | 7.5K | $158.3K | $21.23 | 2.54x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.5K | $112.3K | $75.83 | 1.57x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 847 | $98.2K | $115.98 | 1.52x |
| 92557 | Air and bone conduction assessment of hearing loss and speech recognition | 1.8K | $54.2K | $29.51 | 1.97x |
| 31505 | Diagnostic examination of voice box using an endoscope | 1.2K | $44.9K | $38.65 | 2.53x |
| 92588 | Placement of ear probe for computerized cochlear assessment of repeated sounds with interpretation and report | 1.5K | $37.8K | $26.03 | 1.38x |
| 0486T | Oct scan of both ears | 909 | $34.5K | $37.93 | 4.02x |
| 92567 | Eardrum testing using ear probe | 1.8K | $20.5K | $11.47 | 1.39x |
| 95992 | Repositioning maneuvers for treatment of vertigo, per day | 570 | $19.9K | $34.92 | 1.63x |
| 92552 | Pure tone air conduction threshold hearing assessment | 447 | $11.5K | $25.70 | 3.20x |
| 69420 | Incision, aspiration, and/or inflation of eardrum | 28 | $4.6K | $164.65 | 1.35x |
| 42650 | Insertion of probe for salivary gland duct dilation | 30 | $1.3K | $44.22 | 2.12x |
| 99212 | Established patient office or other outpatient visit, typically 10 minutes | 27 | $936.52 | $34.69 | 1.32x |
| 69200 | Removal of foreign body from ear canal | 21 | $923.07 | $43.96 | 4.03x |
This provider submits charges 1.73 times higher than what Medicare actually pays.
A markup ratio of 1.73x means for every $100 Medicare pays, this provider initially charges $173. This is lower 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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