This provider's $7.0M in total Medicare payments ranks in the 99th percentile of Otolaryngology providers nationally.
Medicare payments to this provider grew 58% 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 | $612.39 | $170.95 | 3.58x | $441.44 | $587.0K | 6.5K | 4.7K |
| 2015 | $611.80 | $166.59 | 3.67x | $445.21 | $565.1K | 6.2K | 4.4K |
| 2016 | $662.22 | $181.60 | 3.65x | $480.62 | $572.7K | 6.4K | 4.5K |
| 2017 | $698.73 | $180.86 | 3.86x | $517.87 | $629.5K | 6.7K | 5.0K |
| 2018 | $663.50 | $158.00 | 4.20x | $505.50 | $668.3K | 7.5K | 5.6K |
| 2019 | $700.05 | $182.02 | 3.85x | $518.03 | $756.1K | 8.2K | 5.8K |
| 2020 | $798.26 | $194.86 | 4.10x | $603.40 | $658.5K | 7.7K | 5.3K |
| 2021 | $735.75 | $182.87 | 4.02x | $552.88 | $779.1K | 8.7K | 5.7K |
| 2022 | $976.54 | $222.48 | 4.39x | $754.06 | $897.2K | 8.9K | 6.1K |
| 2023 | $824.12 | $174.22 | 4.73x | $649.90 | $924.9K | 9.2K | 6.2K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 31231 | Diagnostic examination of nasal passages using an endoscope | 10.0K | $1.6M | $164.91 | 3.80x |
| 99214 | Established patient office or other outpatient, visit typically 25 minutes | 10.5K | $921.7K | $87.69 | 3.65x |
| 99213 | Established patient office or other outpatient visit, typically 15 minutes | 13.7K | $814.6K | $59.34 | 4.02x |
| 99204 | New patient office or other outpatient visit, typically 45 minutes | 4.8K | $588.6K | $123.85 | 3.78x |
| 92511 | Examination of the nose and throat using an endoscope | 5.5K | $535.3K | $96.69 | 3.73x |
| 31295 | Dilation of nasal sinus using an endoscope | 194 | $403.4K | $2.1K | 4.03x |
| 31579 | Examination to assess movement of vocal cord flaps using an endoscope | 1.5K | $233.1K | $156.87 | 3.55x |
| 31237 | Biopsy or removal of nasal polyp or tissue using an endoscope | 718 | $210.3K | $292.92 | 4.68x |
| 69210 | Removal of impact ear wax, one ear | 5.5K | $192.7K | $34.98 | 4.35x |
| 31238 | Control of nasal bleeding using an endoscope | 734 | $175.9K | $239.61 | 4.12x |
| 76536 | Ultrasound of head and neck | 2.6K | $168.1K | $64.47 | 5.01x |
| 92614 | Evaluation and recording of voice box sensory function using an endoscope | 1.2K | $138.6K | $119.91 | 3.19x |
| 95810 | Sleep monitoring of patient (6 years or older) in sleep lab | 322 | $126.6K | $393.15 | 3.83x |
| 95811 | Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube | 250 | $106.6K | $426.44 | 3.92x |
| 31233 | Examination of nasal passage and sinus using an endoscope | 390 | $91.4K | $234.33 | 4.99x |
| 99203 | New patient office or other outpatient visit, typically 30 minutes | 1.1K | $84.9K | $78.81 | 3.46x |
| 95165 | Preparation and provision of single or multiple antigens for allergen immunotherapy | 5.0K | $58.7K | $11.75 | 3.86x |
| 31235 | Examination of nasal passages and sinus using an endoscope via sinus puncture | 157 | $53.7K | $341.91 | 4.11x |
| 99215 | Established patient office or other outpatient, visit typically 40 minutes | 471 | $51.7K | $109.73 | 2.96x |
| 10005 | Fine needle aspiration of first lesion using ultrasound guidance | 363 | $40.0K | $110.24 | 3.45x |
This provider submits charges 3.89 times higher than what Medicare actually pays.
A markup ratio of 3.89x means for every $100 Medicare pays, this provider initially charges $389. 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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