Surgical disputes are lower in volume than emergency medicine but carry the highest award multiples in the program — median surgical determinations were 1,449% of QPA in Q3 2025 and 1,279% in Q4.
Payer QPAs for surgical procedures are frequently very low — CMS analysis of 2024 data found a median QPA of about $213 among surgical determinations where the prevailing offer exceeded 3,000% of QPA. When the initial payment bears little relation to the work involved, arbiters have consistently sided with the provider.
Case-by-case eligibility screening (surgical claims are less batchable), offer construction built on complexity, training, and comparable-award evidence, and disciplined deadline management on every case.
90 days of out-of-network remits, your payer list, and a signed authorization. We return a claim-level eligibility report and projected recovery within a week.
Free eligibility reviewSend us a sample of recent OON remits. We'll tell you which claims are IDR-eligible, what similar disputes have paid, and what we'd file. No fee unless we win you more.
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