Federal IDR outcomes: Anesthesiology in Pennsylvania
In 2025 Q1–Q4, the provider or facility offer prevailed in 86.5% of 3,846 determined Federal IDR dispute line items for anesthesiology in Pennsylvania. The median prevailing offer was 8.09x the QPA (25th–75th percentile 5.57x–18.09x; n = 3,681). The median time to a decision was 30 business days (n = 3,846).
Determined line items
3,846
2025 Q1–Q4 · 17 split decisions excluded
Provider win rate
86.5%
n = 3,846 · 2025 Q1–Q4
Median payment vs QPA
8.09x
middle half 5.57x–18.09x · n = 3,681 · 2025 Q1–Q4
Median days to decision
30
business days, from dispute initiation · n = 3,846 · 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 | 3,846 | 86.5% | 8.09x | 5.57x–18.09x | 3,681 | 30 |
| 2024 Q1–Q4 | 844 | 95.7% | 7.59x | 5.25x–9.82x | 507 | 30 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 4,690 | 88.2% | 8.07x | 5.51x–16.57x | 4,188 | 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 |
|---|---|---|---|---|---|
| 00142 Anesthesia for lens surgery | 531 | 82.3% | 18.05x | 520 | 29 |
| 01400 Anesthesia for other procedure or exam of knee joint using an endoscope | 388 | 89.4% | 9.36x | 361 | 29.5 |
| 01480 Anesthesia for other procedure on lower leg, ankle, and foot bones | 276 | 86.6% | 8.96x | 254 | 31 |
| 01630 Anesthesia for other procedure on top of arm bone and shoulder joint | 219 | 87.7% | 8.05x | 205 | 28 |
| 01402 Anesthesia for procedure for total knee joint replacement | 179 | 89.9% | 6.76x | 172 | 33 |
| 01810 Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wri | 143 | 92.3% | 10.89x | 139 | 29 |
| 64415 Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial ple | 124 | 86.3% | 13.36x | 114 | 30 |
| 01214 Anesthesia for total hip replacement | 109 | 88.1% | 7.27x | 109 | 29 |
| 64447 Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve) | 93 | 89.2% | 18.75x | 87 | 31 |
| 64445 Injection of anesthetic agent and/or steroid into lower back and leg nerve (scia | 92 | 87.0% | 15.64x | 82 | 32 |
| 00812 Anesthesia for exam of colon using an endoscope | 88 | 89.8% | 7.85x | 88 | 33.5 |
| 00400 Anesthesia for other procedure on skin of arms, legs, and front body | 87 | 85.1% | 7.77x | 85 | 29 |
| 01470 Anesthesia for other procedure on nerves, muscles, tendons, and tissue of lower | 86 | 90.7% | 9.75x | 82 | 27 |
| 00840 Anesthesia for other procedure on lower abdomen | 83 | 86.7% | 7.56x | 81 | 33 |
| 00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using | 57 | 91.2% | 7.87x | 55 | 26 |
| 00160 Anesthesia for other procedure on nose and sinuses | 55 | 89.1% | 6.41x | 55 | 29 |
| 00790 Anesthesia for other procedure on upper abdomen | 52 | 76.9% | 7.51x | 52 | 31 |
| 00140 Anesthesia for other procedure on eye | 51 | 88.2% | 8.22x | 51 | 26 |
| 00918 Anesthesia for fragmenting, manipulation and/or removal of kidney stone includin | 51 | 90.2% | 7.89x | 51 | 37 |
| 01830 Anesthesia for other procedure on forearm, wrist, or hand bones | 45 | 82.2% | 5.77x | 42 | 31 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Pennsylvania · Anesthesiology in all states
FAQ
What is the Federal IDR provider win rate for anesthesiology in Pennsylvania?
In 2025 Q1–Q4, the provider or facility offer was selected in 86.5% of 3,846 determined dispute line items for anesthesiology in Pennsylvania. 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 Pennsylvania?
In 2025 Q1–Q4, the median prevailing offer was 8.09x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 5.57x to 18.09x (n = 3,681 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 Pennsylvania?
In 2025 Q1–Q4, the median was 30 business days (n = 3,846 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).