How many surgical assistant disputes are in the published record?

17,926 across the 2023 through 2025 public use files, with an 89.8 percent win rate on decided disputes and a median award of $12,203.

Why do assistant claims win at such a high rate?

The consent defense is unavailable because assistants are never-waivable, the underlying case complexity supports the offer, and published prior awards anchor each submission against QPAs built from percentage-of-primary contract terms.

Is the assistant record growing?

The record covers 17,926 disputes over three years against a national flow of out-of-network assists far larger. Most eligible assist claims have never been filed, which is the opportunity the published win rate describes.

Answers / The assistant record

The surgical assistant IDR record

The 2023 through 2025 CMS public use files contain 17,926 federal IDR disputes with surgical assistant line items. Assistants won 89.8 percent of decided disputes, near the top of the published tables, with a median decided award of $12,203. Assistant claims are never waivable under the No Surprises Act, so nearly every out-of-network assist at an in-network facility was eligible.

A record built on small benchmarks

Surgical assistant line items appear in 17,926 published No Surprises Act disputes across 2023 through 2025. The decided win rate, 89.8 percent, sits near the top of every specialty table in the files. The median decided award was $12,203. Behind those numbers is a benchmark problem that favors the filer: assist lines are contracted as percentages of primary fees, the resulting QPAs are small, and arbitrators asked to choose between a percentage-of-a-discount and a documented offer have overwhelmingly chosen the offer.

Nine of ten decided filings

An 89.8 percent decided win rate leaves little room for argument about base rates. Assist claims arrive in arbitration with structural advantages: the never-waivable status removes the consent defense entirely, the complexity of the underlying case transfers to the assist line, and the published record of prior assistant awards anchors each new offer. A payer defending a small QPA on a complex spine assist is defending the least defensible number in the room.

The volume hiding in plain sight

Every complex case staffed out-of-network produces an assist claim alongside the primary claim: spine instrumentations, joint revisions, cardiac cases, complex abdominal work. Dedicated assist services generate dozens of eligible encounters per week per facility relationship. Measured against that flow, 17,926 disputes over three years is a thin slice. The record is strong because the filers who showed up won; it is small because almost nobody has shown up.

Economics at assistant scale

Assistant awards run smaller than primary surgeon awards, which makes cost structure decisive. Percentage representation at 15 to 25 percent of a $12,203 median takes $1,800 to $3,000 per decided case; across a monthly batch of assists, the contingency bill rivals payroll. Lido IDR files for a flat fee per arbitration, with offers priced from the record at idrexplorer.com, which is the structure a high-frequency, mid-size claim book actually needs.

Price your assist book against the record

Lido IDR prices assistant offers against published awards on matching codes and payers, then files for a flat fee per arbitration. Talk to an IDR specialist.