Benchmarks › Surgery
Surgery: Federal IDR benchmarks
In 2025-Q4 the median prevailing offer for Surgery (CPT 10004 - 69990) was 1503% of the QPA, across 55,885 payment determinations covering 65,293 items or services.
| Quarter | Median prevailing offer, % of QPA | Determinations | Items or services |
|---|---|---|---|
| 2025-Q1 | 1330% | 36,760 | 45,684 |
| 2025-Q2 | 1319% | 48,614 | 60,387 |
| 2025-Q3 | 1449% | 53,336 | 63,157 |
| 2025-Q4 | 1503% | 55,885 | 65,293 |
Source: CMS Federal IDR Supplemental Tables, reporting year 2025 (CMS reports page). Quarterly medians cannot be combined into a yearly median, so each quarter is shown separately.
What this does and does not tell you
A median describes the middle of past outcomes for the whole specialty. It is not a prediction for a specific claim: the QPA band, the plan, the state, the evidence you submit and the entity all matter. Lower-QPA items tend to see higher multiples; see QPA bands.
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