How many plastic surgery disputes are in the published record?

41,565 across the 2023 through 2025 public use files, the largest count of any surgical specialty, with an 89.2 percent win rate on decided disputes.

What is the median plastic surgery IDR award?

$30,000 across decided 2023 through 2025 disputes, among the largest specialty medians in the published record.

Why does plastic surgery file more than other surgical specialties?

Low network participation, heavy ED call coverage for facial and hand trauma, and insured reconstructive volume. Each produces out-of-network claims at the facility types the No Surprises Act covers.

Answers / The plastic surgery record

The plastic surgery IDR record

CMS published 41,565 federal IDR disputes with plastic and reconstructive surgery line items across the 2023 through 2025 files, more than any other surgical specialty. Plastic surgeons won 89.2 percent of decided disputes, and the median decided award was $30,000. The volume is driven by emergency call coverage and insured reconstructive work, both protected under the No Surprises Act.

The biggest surgical book in the record

Among surgical specialties in the published No Surprises Act files, plastic and reconstructive surgery files the most: 41,565 disputes across 2023 through 2025. That outpaces orthopedics, neurosurgery, and general surgery. The specialty's out-of-network footprint explains it. Plastic surgeons participate in networks at low rates, cover enormous amounts of hospital call, and perform insured reconstructive work that payers price against benchmarks built from thin contract data.

A win rate near the top of the table

Arbitrators sided with the plastic surgeon in 89.2 percent of decided disputes, one of the highest rates of any specialty at any volume. The median decided award was $30,000. Hold those two numbers together: this is a specialty where nine of ten decided filings win, and the typical win is five figures. For a group with an out-of-network book, the published base rate is not a close call.

What fills the 41,565

The caseload behind the number is the specialty's insured core. Facial fractures and complex lacerations from ED call. Hand and digit emergencies. Breast reconstruction after mastectomy, which federal law separately requires plans to cover. Post-traumatic and post-oncologic repairs staged across months. Each is work performed on an insured patient, frequently out-of-network, at exactly the facility types the statute covers, which is why the specialty's claims flow into arbitration at this scale.

Using the record

Every decided dispute is published, which means a filing surgeon today can anchor an offer to thousands of prior decided plastic surgery outcomes rather than argue from charges. The full dataset is explorable at idrexplorer.com, down to codes and payers. Lido IDR builds its offers on that record and files for a flat fee per arbitration, so the award stays with the surgeon who took the call.

Anchor every offer to a decided award

Lido IDR prices reconstructive offers from the published decisions on matching codes and payers, and files each dispute for a flat fee per arbitration. Talk to an IDR specialist.