Federal IDR outcomes: Anesthesiology in Virginia
In 2025 Q1–Q4, the provider or facility offer prevailed in 79.6% of 5,792 determined Federal IDR dispute line items for anesthesiology in Virginia. The median prevailing offer was 3.57x the QPA (25th–75th percentile 1.61x–6.37x; n = 5,685). The median time to a decision was 30 business days (n = 5,792).
Determined line items
5,792
2025 Q1–Q4 · 72 split decisions excluded
Provider win rate
79.6%
n = 5,792 · 2025 Q1–Q4
Median payment vs QPA
3.57x
middle half 1.61x–6.37x · n = 5,685 · 2025 Q1–Q4
Median days to decision
30
business days, from dispute initiation · n = 5,792 · 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 | 5,792 | 79.6% | 3.57x | 1.61x–6.37x | 5,685 | 30 |
| 2024 Q1–Q4 | 201 | 72.1% | 1.49x | 1.25x–2.22x | 182 | 136 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 6,016 | 79.4% | 3.43x | 1.52x–6.34x | 5,888 | 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 |
|---|---|---|---|---|---|
| 00812 Anesthesia for exam of colon using an endoscope | 929 | 84.1% | 2.70x | 918 | 35 |
| 00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using | 462 | 87.2% | 3.21x | 461 | 33 |
| 00840 Anesthesia for other procedure on lower abdomen | 352 | 77.6% | 5.90x | 347 | 29 |
| 00811 Anesthesia for other procedure on large bowel using an endoscope | 263 | 81.4% | 2.70x | 256 | 39 |
| 00813 Anesthesia for procedure on small and large bowel using an endoscope | 239 | 82.4% | 3.58x | 238 | 31 |
| 01967 Anesthesia for labor during planned vaginal delivery | 213 | 75.6% | 2.27x | 212 | 25 |
| 01961 Anesthesia for cesarean delivery | 202 | 87.6% | 6.12x | 200 | 30.5 |
| 00790 Anesthesia for other procedure on upper abdomen | 191 | 74.3% | 5.44x | 183 | 33 |
| 00952 Anesthesia for exam of uterus using an endoscope | 115 | 77.4% | 5.95x | 107 | 30 |
| 01400 Anesthesia for other procedure or exam of knee joint using an endoscope | 110 | 50.9% | 2.99x | 103 | 44 |
| 00400 Anesthesia for other procedure on skin of arms, legs, and front body | 106 | 86.8% | 3.66x | 106 | 34 |
| 00160 Anesthesia for other procedure on nose and sinuses | 96 | 82.3% | 3.94x | 94 | 26.5 |
| 01480 Anesthesia for other procedure on lower leg, ankle, and foot bones | 93 | 72.0% | 3.55x | 89 | 33 |
| 00537 Anesthesia for procedure to assess heart electrical activity | 90 | 72.2% | 5.94x | 88 | 29 |
| 00402 Anesthesia for reconstruction of breast | 87 | 78.2% | 6.02x | 85 | 29 |
| 00170 Anesthesia for other procedure on mouth | 86 | 84.9% | 5.92x | 86 | 26 |
| 01922 Anesthesia for X-ray or radiation therapy | 84 | 72.6% | 3.12x | 84 | 23 |
| 00142 Anesthesia for lens surgery | 82 | 75.6% | 3.60x | 81 | 31 |
| 00918 Anesthesia for fragmenting, manipulation and/or removal of kidney stone includin | 76 | 72.4% | 6.04x | 73 | 26.5 |
| 00670 Anesthesia for extensive surgery on spine | 68 | 72.1% | 3.93x | 68 | 26 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Virginia · Anesthesiology in all states
FAQ
What is the Federal IDR provider win rate for anesthesiology in Virginia?
In 2025 Q1–Q4, the provider or facility offer was selected in 79.6% of 5,792 determined dispute line items for anesthesiology in Virginia. 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 Virginia?
In 2025 Q1–Q4, the median prevailing offer was 3.57x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.61x to 6.37x (n = 5,685 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 Virginia?
In 2025 Q1–Q4, the median was 30 business days (n = 5,792 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).