IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Neurosurgery and spine surgery in Pennsylvania

In 2025 Q1–Q4, the provider or facility offer prevailed in 83.8% of 117 determined Federal IDR dispute line items for neurosurgery and spine surgery in Pennsylvania. The median prevailing offer was 61.10x the QPA (25th–75th percentile 21.88x–163.28x; n = 112). The median time to a decision was 34 business days (n = 117).

Determined line items

117

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

83.8%

n = 117 · 2025 Q1–Q4

Median payment vs QPA

61.10x †

middle half 21.88x–163.28x · n = 112 · 2025 Q1–Q4

Median days to decision

34

business days, from dispute initiation · n = 117 · 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–Q411783.8%61.10x †21.88x–163.28x11234
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q413284.1%48.53x †14.10x–138.60x127not 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

No row has 30 or more determined line items in 2025 Q1–Q4.

Related: all specialties in Pennsylvania · Neurosurgery and spine surgery in all states

FAQ

What is the Federal IDR provider win rate for neurosurgery and spine surgery in Pennsylvania?

In 2025 Q1–Q4, the provider or facility offer was selected in 83.8% of 117 determined dispute line items for neurosurgery and spine surgery 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 Withdrawn, settled and ineligible disputes are not in the CMS data.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 neurosurgery and spine surgery in Pennsylvania?

In 2025 Q1–Q4, the median prevailing offer was 61.10x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 21.88x to 163.28x (n = 112 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 Pennsylvania?

In 2025 Q1–Q4, the median was 34 business days (n = 117 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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