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Orthopedic Surgery IDR: win rates and median awards
What Orthopedic Surgery providers win in No Surprises Act arbitration, from 63,605 published disputes.
What do Orthopedic Surgery providers win at federal IDR? In the CMS federal IDR public use files, providers in Orthopedic Surgery won 85.0 percent of decided federal IDR disputes under the No Surprises Act, across 63,605 published disputes. The median award was 29.7x 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.
Orthopedic 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 Orthopedic Surgery billing code, 22853, with a median qualifying payment amount of $113 in the files. A Orthopedic Surgery dispute with a qualifying payment amount of $113 resolves at the specialty median of 29.7x, an estimated award of $3,356. A median is not a floor or a ceiling: half of decided line items in the specialty resolve higher and half lower.
Top Orthopedic Surgery billing codes at federal IDR
The most disputed Orthopedic 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 |
|---|---|---|---|---|
| 22853 | 4,714 | 84.8% | $113 | $24,000 |
| 29584 | 3,512 | 73.5% | $45 | $603 |
| 22551 | 2,491 | 84.7% | $406 | $18,700 |
| 29125 | 2,108 | 79.9% | $75 | $347 |
| 22845 | 2,001 | 84.4% | $181 | $20,000 |
| 29826 | 1,947 | 84.0% | $39 | $6,000 |
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 Orthopedic Surgery federal IDR disputes do providers win?
Providers won 85.0 percent of decided federal IDR disputes in Orthopedic Surgery, across 63,605 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 22853?
Code 22853, the most disputed Orthopedic Surgery code in the files, shows a median decided award of $24,000 against a median qualifying payment amount of $113, with an 84.8 percent provider win rate across 4,714 line items.
How long does a Orthopedic Surgery IDR case take?
The median Orthopedic 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
Neurosurgery & Pain IDR, General Surgery IDR, and Neurodiagnostics & IONM 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.