Federal IDR outcomes: Surgical assistant services in New Jersey
In 2025 Q1–Q4, the provider or facility offer prevailed in 84.6% of 1,079 determined Federal IDR dispute line items for surgical assistant services in New Jersey. The median prevailing offer was 34.91x the QPA (25th–75th percentile 15.12x–77.76x; n = 1,031). The median time to a decision was 39 business days (n = 1,079).
Determined line items
1,079
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
84.6%
n = 1,079 · 2025 Q1–Q4
Median days to decision
39
business days, from dispute initiation · n = 1,079 · 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 | 1,079 | 84.6% | 34.91x † | 15.12x–77.76x | 1,031 | 39 |
| 2024 Q1–Q4 | 1,149 | 85.2% | 22.66x † | 10.46x–39.73x | 1,025 | 33 |
| 2023 Q1–Q4 | 62 | 85.5% | 20.46x † | 7.12x–36.43x | 61 | 28 |
| 2023 Q1–2025 Q4 | 2,290 | 84.9% | 27.68x † | 11.63x–55.67x | 2,117 | 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 |
|---|---|---|---|---|---|
| 29826 Shaving of part of shoulder bone and repair of ligament using an endoscope | 66 | 77.3% | 100.16x † | 64 | 42 |
| 99232 Subsequent hospital care with moderate levelof medical decision making, if using | 56 | 82.1% | 25.68x † | 55 | 41 |
| 29827 Repair of shoulder rotator cuff using an endoscope | 45 | 80.0% | 25.49x † | 44 | 50 |
| 29888 Repair of anterior cruciate ligament of knee using an endoscope | 44 | 79.5% | 33.83x † | 44 | 27.5 |
| 29823 Removal of extensive shoulder joint tissue using an endoscope | 38 | 81.6% | 57.33x † | 38 | 52 |
| 27447 Replacement of knee joint, both sides of knee | 30 | 96.7% | – | 28 | 28 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in New Jersey · Surgical assistant services in all states
FAQ
What is the Federal IDR provider win rate for surgical assistant services in New Jersey?
In 2025 Q1–Q4, the provider or facility offer was selected in 84.6% of 1,079 determined dispute line items for surgical assistant services in New Jersey. 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 surgical assistant services in New Jersey?
In 2025 Q1–Q4, the median prevailing offer was 34.91x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 15.12x to 77.76x (n = 1,031 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 surgical assistant services in New Jersey?
In 2025 Q1–Q4, the median was 39 business days (n = 1,079 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).