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ENT Surgery IDR: win rates and median awards
What ENT Surgery providers win in No Surprises Act arbitration, from 4,569 published disputes.
What do ENT Surgery providers win at federal IDR? In the CMS federal IDR public use files, providers in ENT Surgery won 84.4 percent of decided federal IDR disputes under the No Surprises Act, across 4,569 published disputes. The median award was 6.5x the qualifying payment amount across decided line items in the specialty, and the median time from filing to decision was 31 days. Estimate your own case with the free IDR calculator.
ENT Surgery line items in the CMS federal IDR public use files, 2023 through 2025. Method on the methodology page.
A worked example
Take the most disputed ENT Surgery billing code, 69990, with a median qualifying payment amount of $292 in the files. A ENT Surgery dispute with a qualifying payment amount of $292 resolves at the specialty median of 6.5x, an estimated award of $1,898. A median is not a floor or a ceiling: half of decided line items in the specialty resolve higher and half lower.
Top ENT Surgery billing codes at federal IDR
The most disputed ENT Surgery codes in the public use files, at the line-item grain. Median award is the median decided award in dollars for that code. Win rates are within decided line items for the code.
| Code | Line items | Win rate | Median QPA | Median award |
|---|---|---|---|---|
| 69990 | 820 | 88.5% | $292 | $10,000 |
| 31500 | 668 | 85.0% | $165 | $854 |
| 69209 | 464 | 82.6% | $28 | $257 |
| 69200 | 344 | 85.4% | $92 | $692 |
| 69210 | 328 | 71.6% | $69 | $432 |
| 92653 | 314 | 83.1% | $95 | $638 |
Source: CMS federal IDR public use files, 2023 through 2025. "n/a" means CMS did not publish a usable dollar figure for that code.
Common questions
What percentage of ENT Surgery federal IDR disputes do providers win?
Providers won 84.4 percent of decided federal IDR disputes in ENT Surgery, across 4,569 disputes in the CMS federal IDR public use files. Decided disputes exclude default decisions, where one side never submitted an offer.
What is the median IDR award for code 69990?
Code 69990, the most disputed ENT Surgery code in the files, shows a median decided award of $10,000 against a median qualifying payment amount of $292, with an 88.5 percent provider win rate across 820 line items.
How long does a ENT Surgery IDR case take?
The median ENT Surgery dispute took 31 days from filing to decision. The No Surprises Act process is written only: after the payer's initial payment there are 30 business days to start open negotiation, 30 to negotiate, then 4 to initiate arbitration. There is no hearing.
Related pages
General Surgery IDR, Office & Urgent Care E/M IDR, and Anesthesiology IDR have their own pages, and the IDR calculator covers all 22 specialties. For filing help, Lido IDR files federal IDR for a flat fee per arbitration. To browse every published dispute, see idrexplorer.com.