IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Anesthesiology in West Virginia

In 2025 Q1–Q4, the provider or facility offer prevailed in 85.7% of 2,433 determined Federal IDR dispute line items for anesthesiology in West Virginia. The median prevailing offer was 6.54x the QPA (25th–75th percentile 3.80x–9.08x; n = 2,425). The median time to a decision was 31 business days (n = 2,433).

Determined line items

2,433

2025 Q1–Q4 · 12 split decisions excluded

Provider win rate

85.7%

n = 2,433 · 2025 Q1–Q4

Median payment vs QPA

6.54x

middle half 3.80x–9.08x · n = 2,425 · 2025 Q1–Q4

Median days to decision

31

business days, from dispute initiation · n = 2,433 · 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–Q42,43385.7%6.54x3.80x–9.08x2,42531
2024 Q1–Q419898.5%2.32x2.32x–4.14x19824
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q42,63186.6%6.44x3.40x–8.80x2,623not 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 endoscope29188.7%6.37x29029
00840 Anesthesia for other procedure on lower abdomen21583.3%6.44x21331
00731 Anesthesia for other procedure on esophagus, stomach, or upper small bowel using17383.8%7.33x17328
00790 Anesthesia for other procedure on upper abdomen12989.1%7.33x12931
00813 Anesthesia for procedure on small and large bowel using an endoscope11889.0%6.88x11826
00811 Anesthesia for other procedure on large bowel using an endoscope10189.1%6.55x10133
01967 Anesthesia for labor during planned vaginal delivery7989.9%5.16x7929
00400 Anesthesia for other procedure on skin of arms, legs, and front body6791.0%7.86x6730
00952 Anesthesia for exam of uterus using an endoscope6578.5%6.74x6427
00170 Anesthesia for other procedure on mouth5874.1%7.36x5836
01400 Anesthesia for other procedure or exam of knee joint using an endoscope5696.4%7.93x5632.5
01961 Anesthesia for cesarean delivery5683.9%4.45x5640.5
01810 Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wri5182.4%7.33x5134
00910 Anesthesia for other procedure on urinary system through urethra4584.4%7.83x4537
00918 Anesthesia for fragmenting, manipulation and/or removal of kidney stone includin4187.8%6.51x4135
01480 Anesthesia for other procedure on lower leg, ankle, and foot bones3894.7%9.48x3825.5
00732 Anesthesia for procedure on gallbladder, pancreas, or liver using an endoscope3290.6%7.99x3220.5
01214 Anesthesia for total hip replacement3190.3%6.77x3128

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

Related: all specialties in West Virginia · Anesthesiology in all states

FAQ

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

In 2025 Q1–Q4, the provider or facility offer was selected in 85.7% of 2,433 determined dispute line items for anesthesiology in West 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 West Virginia?

In 2025 Q1–Q4, the median prevailing offer was 6.54x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.80x to 9.08x (n = 2,425 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 West Virginia?

In 2025 Q1–Q4, the median was 31 business days (n = 2,433 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

How to Utilize IDR