How many trauma surgery disputes are in the published record?

11,215 disputes with general surgery and trauma line items across the 2023 through 2025 public use files, with an 85.3 percent win rate on decided disputes and a median award of $18,991.

Does emergency general surgery have the same IDR protection as trauma?

Yes. EGS cases arriving through the ED are emergency services under the No Surprises Act, protected unconditionally when the surgeon is out-of-network on a commercial claim.

Why do trauma claims win at high rates?

Arbitrators must weigh acuity and complexity alongside the QPA, and trauma sits at the top of both. A submission documenting the actual case routinely beats a benchmark built from median contract rates.

Answers / The trauma record

The trauma surgery IDR record

CMS published 11,215 federal IDR disputes with general surgery and trauma line items across 2023 through 2025. Surgeons won 85.3 percent of the decided ones, with $18,991 as the median decided award. Because emergency services can never be waived under the No Surprises Act, almost all of this work was eligible the moment it happened.

The numbers

The published No Surprises Act record holds 11,215 disputes with general surgery and trauma line items from 2023 through 2025. Arbitrators decided for the surgeon in 85.3 percent of resolved cases, at a median decided award of $18,991. Set against the scale of out-of-network trauma care delivered nationally over those three years, the striking feature of this record is how small it is: most trauma surgeons have never filed, and the ones who did won at rates and sizes that would change a group's collections if applied across a full call book.

Acuity is evidence

Federal arbitrators must consider case acuity and complexity alongside the QPA, and trauma occupies the far end of both scales. The damage-control laparotomy, the multi-system activation, the night case with massive transfusion: these are claims where the statute's non-QPA factors do real work. The payer's benchmark reflects the median contracted price of a code; the submission reflects what happened in the operating room. The 85.3 percent decided win rate is what that contest produced.

Emergency general surgery counts too

The record is wider than activations. Emergency general surgery, the appendectomy, the perforated ulcer, the incarcerated hernia, the cholecystitis that cannot wait, qualifies under the same emergency protection when the surgeon is out-of-network. For acute care surgery groups, the EGS book is often larger than the trauma book and produces the same protected claims. The published medians apply to it just as directly.

Check the record before you file

Every decided dispute is published. A trauma group can check what comparable lines paid, by code and by payer, at idrexplorer.com before deciding anything. Lido IDR sets its offers from that record, then files for a flat fee per arbitration, so the award stays with the group that took the call.

Price your call book against the record

Lido IDR anchors trauma and EGS offers to decided awards on matching codes and payers, filing each one for a flat fee per arbitration. Talk to an IDR specialist.