IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Anesthesiology in Michigan

In 2025 Q1–Q4, the provider or facility offer prevailed in 94.4% of 3,938 determined Federal IDR dispute line items for anesthesiology in Michigan. The median prevailing offer was 7.42x the QPA (25th–75th percentile 6.36x–8.56x; n = 3,932). The median time to a decision was 35 business days (n = 3,938).

Determined line items

3,938

2025 Q1–Q4 · 6 split decisions excluded

Provider win rate

94.4%

n = 3,938 · 2025 Q1–Q4

Median payment vs QPA

7.42x

middle half 6.36x–8.56x · n = 3,932 · 2025 Q1–Q4

Median days to decision

35

business days, from dispute initiation · n = 3,938 · 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

PeriodLine itemsWin %Median ×QPA25th–75thRatio nMedian days
2025 Q1–Q43,93894.4%7.42x6.36x–8.56x3,93235
2024 Q1–Q419599.5%3.22x3.21x–3.26x19522
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q44,13394.7%7.26x5.54x–8.39x4,127not 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 codeLine itemsWin %Median ×QPARatio nMedian days
00812 Anesthesia for exam of colon using an endoscope37493.6%8.17x37435
00840 Anesthesia for other procedure on lower abdomen35893.0%7.23x35837
01967 Anesthesia for labor during planned vaginal delivery20195.0%3.58x20131
00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using19996.0%7.78x19936
01961 Anesthesia for cesarean delivery18895.2%7.56x18833
00952 Anesthesia for exam of uterus using an endoscope16692.8%6.81x16632.5
00790 Anesthesia for other procedure on upper abdomen15097.3%7.34x15032.5
00811 Anesthesia for other procedure on large bowel using an endoscope12792.9%6.91x12736
00813 Anesthesia for procedure on small and large bowel using an endoscope10091.0%7.62x10031
00400 Anesthesia for other procedure on skin of arms, legs, and front body9398.9%7.66x9337
01480 Anesthesia for other procedure on lower leg, ankle, and foot bones7892.3%7.83x7836.5
00320 Anesthesia for other procedure on neck area (1 year or older)7692.1%7.13x7634.5
01922 Anesthesia for X-ray or radiation therapy7597.3%7.55x7536
00910 Anesthesia for other procedure on urinary system through urethra7397.3%7.94x7337
00170 Anesthesia for other procedure on mouth7293.1%7.78x7236
00300 Anesthesia for other procedure on skin, muscles, or nerves of head, neck, and up7095.7%6.91x7035
00940 Anesthesia for other procedure on female genitals6096.7%8.01x6039.5
00160 Anesthesia for other procedure on nose and sinuses5596.4%7.46x5529
00902 Anesthesia for procedure on anus and rectum5596.4%7.21x5540
01968 Anesthesia for cesarean delivery following labor5384.9%7.66x5332

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

Related: all specialties in Michigan · Anesthesiology in all states

FAQ

What is the Federal IDR provider win rate for anesthesiology in Michigan?

In 2025 Q1–Q4, the provider or facility offer was selected in 94.4% of 3,938 determined dispute line items for anesthesiology in Michigan. 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 Michigan?

In 2025 Q1–Q4, the median prevailing offer was 7.42x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 6.36x to 8.56x (n = 3,932 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 Michigan?

In 2025 Q1–Q4, the median was 35 business days (n = 3,938 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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