Federal IDR outcomes: Anesthesiology
In 2025 Q1–Q4, the provider or facility offer prevailed in 83.5% of 367,863 determined Federal IDR dispute line items for anesthesiology. The median prevailing offer was 3.36x the QPA (25th–75th percentile 2.06x–8.91x; n = 315,532). The median time to a decision was 34 business days (n = 367,863).
Specialty group built from the CMS free-text specialty field; see the grouping rules.
Determined line items
367,863
2025 Q1–Q4 · 777 split decisions excluded
Provider win rate
83.5%
n = 367,863 · 2025 Q1–Q4
Median payment vs QPA
3.36x
middle half 2.06x–8.91x · n = 315,532 · 2025 Q1–Q4
Median days to decision
34
business days, from dispute initiation · n = 367,863 · 2025 Q1–Q4
Dollar amounts are not shown for specialty groups: the CMS QPA and Offers file, the only source of dollar figures, has no specialty field. See methodology.
By period
| Period | Line items | Win % | Median ×QPA | 25th–75th | Ratio n | Median days |
|---|---|---|---|---|---|---|
| 2025 Q1–Q4 | 367,863 | 83.5% | 3.36x | 2.06x–8.91x | 315,532 | 34 |
| 2024 Q1–Q4 | 124,028 | 86.3% | 3.07x | 1.77x–8.00x | 97,608 | 56 |
| 2023 Q1–Q4 | 12,479 | 84.6% | 2.07x | 1.68x–3.92x | 9,143 | 63 |
| 2023 Q1–2025 Q4 | 504,370 | 84.2% | 3.29x | 1.96x–8.50x | 422,283 | not pooled |
Line items = determined dispute line items (n). Win rate excludes split decisions and includes default decisions. Ratio n = line items reporting a payment-to-QPA ratio. Days are business days as reported by CMS (2023–2024: from IDR entity assignment; 2025: from initiation) and are never pooled.
By state
| State (place of service) | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| Florida | 80,734 | 82.6% | 2.27x | 54,078 | 43 |
| Texas | 79,198 | 86.9% | 3.42x | 74,529 | 30 |
| Arizona | 57,846 | 80.8% | 14.47x | 52,493 | 29 |
| New Jersey | 18,969 | 84.1% | 3.36x | 10,311 | 37 |
| Tennessee | 18,270 | 88.4% | 2.21x | 17,378 | 39 |
| Ohio | 17,259 | 85.7% | 2.52x | 16,983 | 37 |
| Missouri | 13,889 | 82.7% | 9.49x | 12,742 | 33 |
| North Carolina | 11,028 | 90.0% | 1.96x | 9,686 | 34 |
| New York | 8,961 | 78.0% | 5.52x | 8,790 | 34 |
| Louisiana | 5,894 | 59.4% | 8.39x | 5,623 | 84 |
| Virginia | 5,792 | 79.6% | 3.57x | 5,685 | 30 |
| Oklahoma | 5,184 | 91.0% | 10.92x | 4,151 | 31 |
| Indiana | 4,999 | 78.0% | 4.25x | 4,947 | 30 |
| Georgia | 4,419 | 71.2% | 3.28x | 4,145 | 34 |
| Michigan | 3,938 | 94.4% | 7.42x | 3,932 | 35 |
| Pennsylvania | 3,846 | 86.5% | 8.09x | 3,681 | 30 |
| Kentucky | 3,409 | 80.0% | 5.39x | 3,368 | 30 |
| Colorado | 3,009 | 78.6% | 2.56x | 3,006 | 24 |
| Illinois | 2,879 | 90.3% | 5.40x | 2,872 | 28 |
| West Virginia | 2,433 | 85.7% | 6.54x | 2,425 | 31 |
| California | 2,209 | 81.2% | 3.94x | 2,113 | 24 |
| Wisconsin | 1,566 | 77.5% | 1.96x | 1,552 | 26 |
| Maryland | 1,499 | 87.9% | 6.00x | 1,476 | 31 |
| South Carolina | 1,485 | 78.6% | 3.54x | 1,454 | 43 |
| Alabama | 1,426 | 88.6% | 7.43x | 1,146 | 30 |
| South Dakota | 1,398 | 54.9% | 2.86x | 1,398 | 25 |
| Delaware | 1,219 | 89.4% | 4.59x | 1,219 | 28 |
| Arkansas | 1,209 | 76.3% | 3.57x | 958 | 34 |
| Idaho | 716 | 88.3% | 3.85x | 715 | 27 |
| Alaska | 661 | 83.4% | 2.00x | 201 | 23 |
| Kansas | 572 | 87.8% | 8.58x | 561 | 26 |
| Nevada | 410 | 83.9% | 20.57x † | 405 | 27 |
| Massachusetts | 346 | 79.2% | 2.86x | 346 | 52 |
| Nebraska | 330 | 81.5% | 3.94x | 330 | 27 |
| Mississippi | 280 | 84.3% | 4.51x | 277 | 31 |
| Oregon | 172 | 98.3% | 2.20x | 172 | 32 |
| New Mexico | 122 | 95.9% | 5.60x | 120 | 26.5 |
| Washington | 80 | 100.0% | 3.98x | 80 | 32 |
| Connecticut | 76 | 89.5% | 2.23x | 76 | 37 |
| Utah | 54 | 88.9% | 3.17x | 33 | 24 |
| New Hampshire | 47 | 97.9% | 2.85x | 47 | 71 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Most disputed CPT codes
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 00812 Anesthesia for exam of colon using an endoscope | 48,637 | 80.5% | 4.33x | 43,806 | 34 |
| 00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using | 22,898 | 83.0% | 3.76x | 19,886 | 34 |
| 00813 Anesthesia for procedure on small and large bowel using an endoscope | 17,146 | 81.4% | 4.09x | 15,166 | 35 |
| 00840 Anesthesia for other procedure on lower abdomen | 16,573 | 86.3% | 3.00x | 13,820 | 35 |
| 00811 Anesthesia for other procedure on large bowel using an endoscope | 14,398 | 80.4% | 3.67x | 13,033 | 34 |
| 01967 Anesthesia for labor during planned vaginal delivery | 12,168 | 83.5% | 2.58x | 9,260 | 33 |
| 00790 Anesthesia for other procedure on upper abdomen | 11,124 | 85.3% | 2.96x | 9,143 | 35 |
| 01400 Anesthesia for other procedure or exam of knee joint using an endoscope | 9,887 | 84.0% | 3.41x | 8,720 | 34 |
| 01480 Anesthesia for other procedure on lower leg, ankle, and foot bones | 7,752 | 83.9% | 3.46x | 6,628 | 35 |
| 00142 Anesthesia for lens surgery | 7,557 | 81.0% | 5.05x | 6,843 | 31 |
| 01961 Anesthesia for cesarean delivery | 7,078 | 87.1% | 2.63x | 5,626 | 35 |
| 01630 Anesthesia for other procedure on top of arm bone and shoulder joint | 6,803 | 83.9% | 3.60x | 6,022 | 33 |
| 00400 Anesthesia for other procedure on skin of arms, legs, and front body | 6,703 | 85.2% | 3.24x | 5,530 | 35 |
| 01810 Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wri | 6,541 | 83.8% | 3.70x | 5,614 | 34 |
| 00170 Anesthesia for other procedure on mouth | 6,533 | 80.9% | 3.34x | 5,795 | 34 |
| 01402 Anesthesia for procedure for total knee joint replacement | 6,133 | 85.0% | 3.14x | 5,419 | 33 |
| 00952 Anesthesia for exam of uterus using an endoscope | 5,831 | 85.2% | 3.08x | 4,990 | 34 |
| 00160 Anesthesia for other procedure on nose and sinuses | 5,656 | 82.5% | 3.26x | 4,974 | 33 |
| 00670 Anesthesia for extensive surgery on spine | 5,284 | 86.2% | 2.77x | 4,480 | 32 |
| 01992 Anesthesia for nerve block and injection procedure, prone position | 4,725 | 83.3% | 23.05x † | 4,309 | 27 |
| 00300 Anesthesia for other procedure on skin, muscles, or nerves of head, neck, and up | 4,655 | 84.5% | 3.13x | 3,920 | 35 |
| 00902 Anesthesia for procedure on anus and rectum | 4,583 | 85.1% | 3.22x | 3,955 | 33 |
| 00918 Anesthesia for fragmenting, manipulation and/or removal of kidney stone includin | 4,086 | 86.1% | 3.04x | 3,487 | 35 |
| 01830 Anesthesia for other procedure on forearm, wrist, or hand bones | 3,842 | 81.8% | 3.29x | 3,243 | 33 |
| 01214 Anesthesia for total hip replacement | 3,791 | 85.3% | 2.86x | 3,358 | 33 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
FAQ
What is the Federal IDR provider win rate for anesthesiology?
In 2025 Q1–Q4, the provider or facility offer was selected in 83.5% of 367,863 determined dispute line items for anesthesiology. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.
How do Federal IDR payments compare with the QPA for anesthesiology?
In 2025 Q1–Q4, the median prevailing offer was 3.36x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.06x to 8.91x (n = 315,532 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.
How long do Federal IDR decisions take for anesthesiology?
In 2025 Q1–Q4, the median was 34 business days (n = 367,863 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).