Federal IDR outcomes: Intraoperative neuromonitoring

In 2025 Q1–Q4, the provider or facility offer prevailed in 87.2% of 240,382 determined Federal IDR dispute line items for intraoperative neuromonitoring. The median prevailing offer was 22.64x the QPA (25th–75th percentile 8.76x–63.95x; n = 196,412). The median time to a decision was 33 business days (n = 240,382).

Specialty group built from the CMS free-text specialty field; see the grouping rules.

Determined line items

240,382

2025 Q1–Q4 · 214 split decisions excluded

Provider win rate

87.2%

n = 240,382 · 2025 Q1–Q4

Median payment vs QPA

22.64x †

middle half 8.76x–63.95x · n = 196,412 · 2025 Q1–Q4

Median days to decision

business days, from dispute initiation · n = 240,382 · 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	240,382	87.2%	22.64x †	8.76x–63.95x	196,412	33
2024 Q1–Q4	124,261	88.7%	14.17x	6.89x–30.00x	100,598	55
2023 Q1–Q4	10,776	77.9%	9.33x	2.60x–21.30x	8,764	71
2023 Q1–2025 Q4	375,419	87.5%	18.62x	7.63x–49.97x	305,774	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
Texas	58,961	89.1%	47.34x †	47,791	32
Florida	23,653	91.2%	16.94x	20,677	34
New Jersey	13,899	85.0%	25.27x †	10,585	34
Ohio	12,391	81.9%	61.76x †	11,641	33
Georgia	11,922	87.1%	18.88x	7,922	33
Pennsylvania	9,393	86.7%	15.34x	8,097	28
Colorado	9,285	85.2%	18.74x	7,877	35
New York	8,556	85.1%	27.76x †	6,106	43
Arizona	7,777	84.4%	24.89x †	6,938	28
Tennessee	6,158	81.5%	19.49x	5,832	31
Oklahoma	5,791	91.2%	71.72x †	4,798	31
Illinois	5,527	88.4%	12.38x	5,212	30
Missouri	5,364	88.1%	22.00x †	3,354	37
Michigan	5,161	92.3%	29.39x †	1,840	33
California	4,935	87.5%	17.12x	4,320	36
Nevada	4,866	84.8%	13.61x	4,806	34
Virginia	4,284	87.0%	18.04x	3,787	37.5
Indiana	3,927	86.5%	16.13x	3,784	33
Alabama	3,860	85.5%	15.73x	3,538	30
North Carolina	3,169	84.5%	14.81x	2,185	32
Kentucky	2,856	84.9%	75.65x †	2,458	33
Wisconsin	2,833	84.9%	11.46x	2,723	32
Connecticut	2,805	82.8%	18.70x	2,128	37
Arkansas	2,294	86.7%	23.36x †	1,190	33
Kansas	2,185	85.2%	23.81x †	1,119	34
South Carolina	2,158	86.4%	15.88x	1,919	36
Massachusetts	1,990	84.3%	8.51x	1,825	34
Oregon	1,418	82.9%	10.19x	1,142	28
Maryland	1,259	87.9%	24.96x †	944	28
Washington	1,223	90.4%	12.88x	786	31
Utah	1,170	86.5%	13.26x	876	29
Delaware	1,166	90.5%	13.76x	1,131	27
Minnesota	958	90.7%	12.17x	841	29
Rhode Island	947	86.9%	13.27x	928	31
Louisiana	897	77.9%	21.42x †	802	31
Idaho	786	84.5%	13.71x	726	26
Mississippi	565	86.9%	13.20x	505	30
New Mexico	517	87.8%	13.41x	497	32
South Dakota	498	88.8%	16.29x	444	29.5
District of Columbia	447	92.8%	12.53x	353	34
Montana	398	88.9%	13.52x	368	28
Nebraska	388	92.5%	12.74x	230	33
Iowa	384	83.3%	12.91x	245	45
West Virginia	332	90.4%	13.39x	285	26
New Hampshire	292	91.8%	10.06x	251	33.5
Alaska	263	81.4%	8.70x	257	39
Wyoming	156	82.7%	14.30x	106	38
Hawaii	151	89.4%	13.69x	151	26
Maine	138	92.0%	21.28x †	73	29

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
95938 Placement of skin electrodes and measurement of stimulated sites on arms and leg	56,066	87.5%	36.46x †	47,356	33
95941 Continuous remote monitoring of nervous system during operation, each hour	37,162	88.8%	12.81x	31,108	32
95939 Placement of skin electrodes and measurement of central motor stimulation in arm	31,155	87.1%	16.85x	26,565	32
95861 Needle measurement of electrical activity in arm or leg muscles, 2 extremities	22,716	87.5%	16.48x	18,856	33
95870 Needle measurement of electrical activity in arm, leg, trunk or head muscles, li	17,156	86.5%	64.57x †	12,664	34
95955 Measurement of brain wave activity (EEG) outside the brain during surgery	16,442	88.3%	32.52x †	14,045	32
95937 Testing of nerve-muscle junction	14,947	89.3%	61.30x †	10,957	32
95868 Needle measurement of electrical activity in muscles on both sides of body	3,838	87.3%	61.98x †	3,100	30
95940 Continuous monitoring of nervous system during operation, each 15 minutes	3,740	83.2%	21.61x †	2,361	37
95886 Needle measurement of electrical activity in arm or leg muscles, complete study	2,850	84.7%	34.08x †	2,362	31
95865 Needle measurement of electrical activity in voice box muscles	2,227	86.7%	28.46x †	1,776	29
95908 Nerve conduction, 3-4 studies	1,935	88.1%	22.98x †	1,617	31
95867 Needle measurement of electrical activity in muscles on side of body	1,591	88.9%	26.15x †	811	37
95957 Measurement of brain wave activity (EEG), digital analysis	1,477	86.3%	16.69x	1,466	31
95927 Placement of skin electrodes and measurement of stimulated sites in trunk or hea	1,442	87.2%	42.36x †	624	33
95885 Needle measurement of electrical activity in arm or leg muscles, limited study	1,271	86.1%	44.27x †	1,013	35
95907 Nerve conduction, 1-2 studies	1,170	88.6%	34.87x †	1,005	31
95909 Nerve conduction, 5-6 studies	921	87.1%	30.77x †	773	31
95887 Needle measurement of electrical activity in trunk or head muscles	896	84.5%	60.56x †	794	34
51785 Needle measurement and recording of electrical activity of muscles at bladder an	676	89.9%	20.54x †	549	33
95822 Measurement of brain wave activity (EEG), in coma or asleep	594	88.0%	23.70x †	430	30.5
95813 Measurement of brain wave activity (EEG), 61-119 minutes	586	87.4%	22.91x †	495	30
95717 Measurement of brain wave activity (EEG), 2-12 hours with health care profession	393	85.0%	28.46x †	358	30
95999 Other diagnostic neurological or neuromuscular procedure	385	88.1%	2.00x	223	34
95910 Nerve conduction, 7-8 studies	371	87.3%	19.66x	301	31

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

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FAQ

What is the Federal IDR provider win rate for intraoperative neuromonitoring?

In 2025 Q1–Q4, the provider or facility offer was selected in 87.2% of 240,382 determined dispute line items for intraoperative neuromonitoring. 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 intraoperative neuromonitoring?

In 2025 Q1–Q4, the median prevailing offer was 22.64x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 8.76x to 63.95x (n = 196,412 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 intraoperative neuromonitoring?

In 2025 Q1–Q4, the median was 33 business days (n = 240,382 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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