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General Surgery IDR: win rates and median awards
What General Surgery providers win in No Surprises Act arbitration, from 75,097 published disputes.
What do General Surgery providers win at federal IDR? In the CMS federal IDR public use files, providers in General Surgery won 86.6 percent of decided federal IDR disputes under the No Surprises Act, across 75,097 published disputes. The median award was 14.1x the qualifying payment amount across decided line items in the specialty, and the median time from filing to decision was 30 days. Estimate your own case with the free IDR calculator.
General 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 General Surgery billing code, 12001, with a median qualifying payment amount of $96 in the files. A General Surgery dispute with a qualifying payment amount of $96 resolves at the specialty median of 14.1x, an estimated award of $1,354. A median is not a floor or a ceiling: half of decided line items in the specialty resolve higher and half lower.
Top General Surgery billing codes at federal IDR
The most disputed General 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 |
|---|---|---|---|---|
| 12001 | 6,083 | 81.1% | $96 | $717 |
| 12002 | 3,524 | 84.7% | $115 | $763 |
| 12011 | 3,513 | 81.7% | $106 | $758 |
| 19318 | 2,973 | 84.0% | $1,430 | $75,000 |
| 10061 | 2,776 | 80.7% | $264 | $1,229 |
| 44970 | 2,558 | 86.2% | $803 | $20,805 |
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 General Surgery federal IDR disputes do providers win?
Providers won 86.6 percent of decided federal IDR disputes in General Surgery, across 75,097 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 12001?
Code 12001, the most disputed General Surgery code in the files, shows a median decided award of $717 against a median qualifying payment amount of $96, with an 81.1 percent provider win rate across 6,083 line items.
How long does a General Surgery IDR case take?
The median General Surgery dispute took 30 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
Orthopedic Surgery IDR, Cardiovascular & Thoracic Surgery 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.