Federal IDR outcomes: Orthopedic surgery in Arizona
In 2025 Q1–Q4, the provider or facility offer prevailed in 90.1% of 354 determined Federal IDR dispute line items for orthopedic surgery in Arizona. The median prevailing offer was 208.63x the QPA (25th–75th percentile 43.34x–495.32x; n = 353). The median time to a decision was 28 business days (n = 354).
Determined line items
354
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
90.1%
n = 354 · 2025 Q1–Q4
Median days to decision
28
business days, from dispute initiation · n = 354 · 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 | 354 | 90.1% | 208.63x † | 43.34x–495.32x | 353 | 28 |
| 2024 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 356 | 90.2% | 205.49x † | 41.70x–495.32x | 355 | 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.
Most disputed CPT codes
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 22853 Insertion of cage or mesh device to spine bone and disc space during spine fusio | 38 | 92.1% | 567.40x † | 38 | 28 |
| 63047 Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 | 38 | 94.7% | 325.86x † | 38 | 25.5 |
| 27130 Replacement of thigh bone and hip joint with prosthesis | 35 | 91.4% | 32.70x † | 35 | 34 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Arizona · Orthopedic surgery in all states
FAQ
What is the Federal IDR provider win rate for orthopedic surgery in Arizona?
In 2025 Q1–Q4, the provider or facility offer was selected in 90.1% of 354 determined dispute line items for orthopedic surgery in Arizona. 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 orthopedic surgery in Arizona?
In 2025 Q1–Q4, the median prevailing offer was 208.63x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 43.34x to 495.32x (n = 353 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 orthopedic surgery in Arizona?
In 2025 Q1–Q4, the median was 28 business days (n = 354 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).