IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Anesthesiology in Texas

In 2025 Q1–Q4, the provider or facility offer prevailed in 86.9% of 79,198 determined Federal IDR dispute line items for anesthesiology in Texas. The median prevailing offer was 3.42x the QPA (25th–75th percentile 2.91x–6.98x; n = 74,529). The median time to a decision was 30 business days (n = 79,198).

Determined line items

79,198

2025 Q1–Q4 · 201 split decisions excluded

Provider win rate

86.9%

n = 79,198 · 2025 Q1–Q4

Median payment vs QPA

3.42x

middle half 2.91x–6.98x · n = 74,529 · 2025 Q1–Q4

Median days to decision

30

business days, from dispute initiation · n = 79,198 · 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–Q479,19886.9%3.42x2.91x–6.98x74,52930
2024 Q1–Q421,22992.0%6.62x4.38x–9.00x16,23534
2023 Q1–Q41,28390.3%2.76x2.00x–6.52x1,10636
2023 Q1–2025 Q4101,71088.0%3.94x2.95x–7.58x91,870not 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 endoscope8,53386.1%4.16x8,25230
00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using4,46688.3%3.76x4,18830
00840 Anesthesia for other procedure on lower abdomen4,03687.2%3.27x3,90229
00813 Anesthesia for procedure on small and large bowel using an endoscope3,47087.1%4.17x3,34631
01967 Anesthesia for labor during planned vaginal delivery3,34784.3%3.09x3,28928
00790 Anesthesia for other procedure on upper abdomen2,90787.0%3.28x2,73829
00811 Anesthesia for other procedure on large bowel using an endoscope2,63184.2%3.45x2,54430
01400 Anesthesia for other procedure or exam of knee joint using an endoscope2,04887.3%3.24x1,94929
01961 Anesthesia for cesarean delivery1,81686.8%3.21x1,76830
01480 Anesthesia for other procedure on lower leg, ankle, and foot bones1,80086.4%3.39x1,62330
00400 Anesthesia for other procedure on skin of arms, legs, and front body1,78785.6%3.52x1,65930
01630 Anesthesia for other procedure on top of arm bone and shoulder joint1,62288.0%3.45x1,50729
00142 Anesthesia for lens surgery1,47390.3%5.60x1,38831
00952 Anesthesia for exam of uterus using an endoscope1,46387.8%3.29x1,37629
00670 Anesthesia for extensive surgery on spine1,35186.5%3.40x1,29229
01810 Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wri1,33287.4%3.35x1,25529
00170 Anesthesia for other procedure on mouth1,25485.6%3.18x1,19229
01402 Anesthesia for procedure for total knee joint replacement1,13987.6%3.24x1,06530
64415 Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial ple1,11189.6%13.81x1,00230
00300 Anesthesia for other procedure on skin, muscles, or nerves of head, neck, and up1,07887.4%3.38x98331

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

Related: all specialties in Texas · Anesthesiology in all states

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 86.9% of 79,198 determined dispute line items for anesthesiology in Texas. 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 Texas?

In 2025 Q1–Q4, the median prevailing offer was 3.42x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.91x to 6.98x (n = 74,529 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 Texas?

In 2025 Q1–Q4, the median was 30 business days (n = 79,198 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

How to Utilize IDR