Federal IDR outcomes: Neurosurgery and spine surgery in New York
In 2025 Q1–Q4, the provider or facility offer prevailed in 87.6% of 6,547 determined Federal IDR dispute line items for neurosurgery and spine surgery in New York. The median prevailing offer was 33.44x the QPA (25th–75th percentile 7.90x–82.37x; n = 5,899). The median time to a decision was 35 business days (n = 6,547).
Determined line items
6,547
2025 Q1–Q4 · 16 split decisions excluded
Provider win rate
87.6%
n = 6,547 · 2025 Q1–Q4
Median days to decision
35
business days, from dispute initiation · n = 6,547 · 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 | 6,547 | 87.6% | 33.44x † | 7.90x–82.37x | 5,899 | 35 |
| 2024 Q1–Q4 | 2,862 | 87.7% | 29.06x † | 10.03x–65.16x | 2,481 | 71 |
| 2023 Q1–Q4 | 442 | 85.3% | 26.43x † | 7.32x–53.64x | 367 | 56 |
| 2023 Q1–2025 Q4 | 9,851 | 87.5% | 31.43x † | 8.80x–76.28x | 8,747 | 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 | 618 | 89.2% | 74.68x † | 576 | 38 |
| 63048 Partial removal of spine bone with release of spinal cord and/or nerves, each ad | 462 | 87.4% | 53.43x † | 421 | 39 |
| 63047 Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 | 366 | 87.4% | 30.63x † | 331 | 35 |
| 22614 Fusion of additional segment of spine | 341 | 86.2% | 30.47x † | 319 | 37 |
| 22551 Fusion of upper spine bone with removal of disc and release of spinal cord or ne | 322 | 86.6% | 25.84x † | 298 | 34 |
| 22552 Fusion of upper spine bone with removal of disc and release of spinal cord or ne | 251 | 88.8% | 60.00x † | 239 | 36 |
| 22842 Placement of stabilizing device to back, 3-6 spine bone segments | 238 | 88.7% | 41.02x † | 228 | 32.5 |
| 22845 Placement of stabilizing device to front, 2-3 spine bone segments | 221 | 86.0% | 36.11x † | 201 | 33 |
| 22840 Placement of stabilizing device to back of 1 spine bone in neck | 183 | 86.9% | 33.89x † | 167 | 34 |
| 22633 Fusion of spine in lower back with partial removal of spine bone and disc | 177 | 91.0% | 28.52x † | 164 | 31 |
| 22612 Fusion of spine in lower back | 171 | 84.2% | 24.22x † | 159 | 34 |
| 63030 Partial removal of spine bone with release of lower spinal cord or nerves and/or | 167 | 85.6% | 20.38x † | 151 | 31 |
| 76000 Imaging guidance for procedure, 60 minutes or less | 153 | 84.3% | 12.07x | 133 | 42 |
| 69990 Use of operating microscope | 146 | 85.6% | 8.16x | 90 | 35 |
| 64722 Release of unspecified nerve | 140 | 85.0% | 117.74x † | 94 | 36 |
| 63052 Partial removal of bone of single segment of spine in lower back with release of | 118 | 90.7% | 123.70x † | 108 | 36 |
| 22600 Fusion of spine in neck by posterior approach | 101 | 89.1% | 29.25x † | 99 | 30 |
| 61783 Computer-assisted spinal procedure | 89 | 91.0% | 69.64x † | 71 | 33 |
| 63045 Partial removal of spine bone with release of upper spinal cord and/or nerves, 1 | 87 | 85.1% | 18.90x | 84 | 31 |
| 20930 Placement of fragmented bone graft or material to spine to promote bone growth | 76 | 86.8% | 0.85x | 52 | 39.5 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in New York · Neurosurgery and spine surgery in all states
FAQ
What is the Federal IDR provider win rate for neurosurgery and spine surgery in New York?
In 2025 Q1–Q4, the provider or facility offer was selected in 87.6% of 6,547 determined dispute line items for neurosurgery and spine surgery in New York. 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 neurosurgery and spine surgery in New York?
In 2025 Q1–Q4, the median prevailing offer was 33.44x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 7.90x to 82.37x (n = 5,899 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 neurosurgery and spine surgery in New York?
In 2025 Q1–Q4, the median was 35 business days (n = 6,547 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).