IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Anesthesiology in South Carolina

In 2025 Q1–Q4, the provider or facility offer prevailed in 78.6% of 1,485 determined Federal IDR dispute line items for anesthesiology in South Carolina. The median prevailing offer was 3.54x the QPA (25th–75th percentile 1.52x–6.40x; n = 1,454). The median time to a decision was 43 business days (n = 1,485).

Determined line items

1,485

2025 Q1–Q4 · 8 split decisions excluded

Provider win rate

78.6%

n = 1,485 · 2025 Q1–Q4

Median payment vs QPA

3.54x

middle half 1.52x–6.40x · n = 1,454 · 2025 Q1–Q4

Median days to decision

43

business days, from dispute initiation · n = 1,485 · 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–Q41,48578.6%3.54x1.52x–6.40x1,45443
2024 Q1–Q41,10286.8%1.68x1.52x–2.11x998148.5
2023 Q1–Q434385.4%1.74x1.40x–2.41x314121
2023 Q1–2025 Q42,93082.5%1.85x1.52x–4.38x2,766not 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 endoscope30684.3%4.54x30636
00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using9679.2%4.73x9629
00813 Anesthesia for procedure on small and large bowel using an endoscope7081.4%5.04x7030.5
00811 Anesthesia for other procedure on large bowel using an endoscope6671.2%3.42x6636
01400 Anesthesia for other procedure or exam of knee joint using an endoscope6489.1%1.59x63114
00160 Anesthesia for other procedure on nose and sinuses55100.0%1.53x55112
00840 Anesthesia for other procedure on lower abdomen5583.6%5.37x5543
00790 Anesthesia for other procedure on upper abdomen4671.7%4.54x4471
00400 Anesthesia for other procedure on skin of arms, legs, and front body3476.5%4.74x3232
01402 Anesthesia for procedure for total knee joint replacement3284.4%–2843
01961 Anesthesia for cesarean delivery3161.3%3.77x3136

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

Related: all specialties in South Carolina · Anesthesiology in all states

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 78.6% of 1,485 determined dispute line items for anesthesiology in South Carolina. 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 South Carolina?

In 2025 Q1–Q4, the median prevailing offer was 3.54x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.52x to 6.40x (n = 1,454 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 South Carolina?

In 2025 Q1–Q4, the median was 43 business days (n = 1,485 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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