Federal IDR outcomes: Neurosurgery and spine surgery in Wisconsin
In 2025 Q1–Q4, the provider or facility offer prevailed in 94.4% of 2,449 determined Federal IDR dispute line items for neurosurgery and spine surgery in Wisconsin. The median prevailing offer was 23.84x the QPA (25th–75th percentile 12.32x–41.59x; n = 2,225). The median time to a decision was 43 business days (n = 2,449).
Determined line items
2,449
2025 Q1–Q4 · 5 split decisions excluded
Provider win rate
94.4%
n = 2,449 · 2025 Q1–Q4
Median days to decision
43
business days, from dispute initiation · n = 2,449 · 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 | 2,449 | 94.4% | 23.84x † | 12.32x–41.59x | 2,225 | 43 |
| 2024 Q1–Q4 | 1,209 | 87.7% | 23.62x † | 10.00x–51.71x | 1,139 | 50 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 3,665 | 92.2% | 23.78x † | 11.52x–43.97x | 3,371 | 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 |
|---|---|---|---|---|---|
| 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using i | 171 | 95.3% | 20.21x † | 160 | 43 |
| 62321 Injection of substance into middle or upper spine canal using imaging guidance | 129 | 93.8% | 20.38x † | 123 | 38 |
| 64772 Incision or removal of spinal nerve | 129 | 93.0% | 50.84x † | 111 | 57 |
| 64484 Injection of anesthetic and/or steroid drug into sacral spine nerve root using i | 112 | 98.2% | 24.08x † | 102 | 40 |
| 64493 Injection of lower or sacral spine facet joint using imaging guidance, single le | 102 | 91.2% | 17.56x | 96 | 43 |
| 99152 Use of a drug to induce depression of consciousness by physician performing a pr | 102 | 98.0% | 22.42x † | 90 | 43 |
| 64490 Injection of upper or middle spine facet joint using imaging guidance, single le | 91 | 96.7% | 20.04x † | 90 | 49 |
| 64494 Injection of lower or sacral spine facet joint using imaging guidance, second le | 81 | 88.9% | 23.62x † | 63 | 36 |
| 72141 MRI scan of upper spinal canal without contrast | 69 | 95.7% | 21.70x † | 63 | 48 |
| 64491 Injection of upper or middle spine facet joint using imaging guidance, second le | 66 | 95.5% | 28.03x † | 63 | 47.5 |
| 36224 Insertion of tube into internal neck artery for diagnosis or treatment with revi | 62 | 96.8% | 42.44x † | 56 | 87.5 |
| 36226 Insertion of tube into brain artery for diagnosis or treatment with review by ra | 61 | 95.1% | 54.87x † | 55 | 47 |
| 72148 MRI scan of lower spinal canal without contrast | 61 | 98.4% | 24.06x † | 57 | 35 |
| 22853 Insertion of cage or mesh device to spine bone and disc space during spine fusio | 58 | 93.1% | 72.34x † | 53 | 46.5 |
| 36227 Insertion of tube into external neck artery for diagnosis or treatment with revi | 49 | 98.0% | 70.10x † | 42 | 72 |
| 27096 Injection of anesthetic or steroid into joint between lower spine and hip bone u | 48 | 95.8% | 17.43x | 48 | 39.5 |
| 72158 MRI scan of lower spinal canal before and after contrast | 39 | 97.4% | 20.91x † | 37 | 45 |
| 72131 CT scan of lower spine without contrast | 38 | 92.1% | 30.49x † | 37 | 35 |
| 22551 Fusion of upper spine bone with removal of disc and release of spinal cord or ne | 37 | 86.5% | 16.50x | 35 | 40 |
| 22842 Placement of stabilizing device to back, 3-6 spine bone segments | 35 | 88.6% | 26.97x † | 33 | 58 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Wisconsin · Neurosurgery and spine surgery in all states
FAQ
What is the Federal IDR provider win rate for neurosurgery and spine surgery in Wisconsin?
In 2025 Q1–Q4, the provider or facility offer was selected in 94.4% of 2,449 determined dispute line items for neurosurgery and spine surgery in Wisconsin. 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 Wisconsin?
In 2025 Q1–Q4, the median prevailing offer was 23.84x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 12.32x to 41.59x (n = 2,225 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 Wisconsin?
In 2025 Q1–Q4, the median was 43 business days (n = 2,449 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).