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Sydra - NSA IDR Software

CMS Federal IDR Public Use Files remain the source for site benchmarks.Where the published federal record ends and Sydra's own client figures begin.

Sydra publishes two different kinds of number, and reading one as the other will mislead you in both directions.

Benchmark figures, such as the roughly 88 percent provider win rate and the median award multiple, come from CMS Federal IDR Public Use Files and independent analyses such as Georgetown CHIR. They describe the federal record across every filer in the dataset. They are not claims about Sydra.

Sydra client outcomes, such as the 92 percent win rate across 113 decided cases shown on the homepage, come from Sydra's own records and are published with client permission. Each carries the denominator and exclusions that make it defensible. This update explains which is which.

Published

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What changed

CMS publishes Federal IDR Public Use Files that summarize resolved disputes under the No Surprises Act. Independent analyses of those files report patterns such as providers prevailing in about 88 percent of resolved federal IDR disputes through the first half of 2025, and about 85 percent of 2024 determinations decided for the provider.

Surgical disputes show the largest multiples in that public record, while surgery and neurology remain a small share of total cases. Those figures update as new public use files publish. When citing a number from this site, name the underlying CMS or Georgetown source and its reporting period rather than treating Sydra as the primary data publisher.

What this means for surgical practices filing IDR

The Federal IDR hub and related resource pages surface payment benchmarks, eligibility context, and dispute outcomes by procedure, state, and payer. The recovery calculator and economics sections use the same published win rate and award multiple inputs so estimates stay tied to public data.

None of those pages claim the aggregate federal win rate as a guarantee for your next dispute. They exist so your team can see the public record before deciding whether to file. Win rate reflects the pattern across many determinations and is not a promise on any single claim.

Where a page shows a Sydra client figure instead, it says so and states the denominator alongside it. A client win rate covers decided cases only for that client over the period measured, and excludes withdrawn, ineligible, and pending disputes. A single award, such as the breast reduction claim awarded 20.30 times its qualifying payment amount, is one outcome and is not typical, average, or expected.

These files are also where the fee history comes from: the administrative fee was cut from $115 to $15 per party, per dispute, by the final rule of May 28, 2026, effective June 11, 2026.

Source

Browse the Federal IDR hub for code, state, and payer context, or open the IDR win rates and awards resource for the sourced figures in one place. If you want help filing eligible claims before their windows close, set up a demo and bring a recent denial from your specialty.

Clinician and a practice advisor reviewing claim figures on a tablet in a hospital lobby

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We'd welcome a short call to see whether this is worth pursuing. Bring one denied out of network claim and you will see what federal IDR would do with it before the call ends.

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Or email sales@sydrahealth.com with a question.

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Sourced references
  1. 1. CMS Federal IDR Q1/Q2 2025 Public Use FileReleased January 21, 2026cms.gov/nosurprises/policies-and-resources/reports
  2. 2. CMS Federal IDR Q4 2025 Public Use FileQuarter 4, 2025. Source for the per CPT area average initial payment and median figures in the Practice A table on the homepage. Geography and median denominator are pending confirmation from ops; see the TODO above PRACTICE_A in src/lib/content/homepage.ts.cms.gov/nosurprises/policies-and-resources/reports
  3. 3. Sydra client records, presented with client permissionProvenance for the Sydra performance figures in SYDRA_PERFORMANCE (src/lib/idr/proof-points.ts): 92% across 113 decided cases, 82.9% across 76 decided cases under the client's prior contingency firm, and the CPT 19318 award of $50,742.00 against a $2,500 QPA. Decided cases only; excludes withdrawn, ineligible, and pending disputes. Not federal data and not a category benchmark.
  4. 4. Georgetown University CHIR · Health Affairs webinarMarch 2026. 3.4 million disputes through June 2025; 88% win rate; median award ~4.5x in network rate
  5. 5. Zelis: NSA IDR Eligibility ChallengesMarch 2026. 44% of 2024 IDR cases challenged as ineligible by non initiating party
  6. 6. ACEP analysis of CMS data~10% of eligible claims estimated to reach IDR arbitration
  7. 7. Brookings Institution NSA Arbitration DatabookApril 2026brookings.edu/articles/no-surprises-act-arbitration-databook
  8. 8. ACR: Providers Prevail in Vast Majority of IDR ClaimsJanuary 2026. 88% of disputes found in provider's favor; 87% of awards exceeded QPA
  9. 9. No Surprises Act: Public Law 116-260, Division BB, Title I
  10. 10. Federal IDR regulations: 45 CFR Part 149ecfr.gov/current/title-45/subtitle-A/subchapter-F/part-149
  11. 11. CMS No Surprises Act overviewcms.gov/nosurprises
  12. 12. HHS HIPAA for professionalshhs.gov/hipaa/for-professionals
  13. 13. CMS Final Rule: No Surprises Act IDR overhaul (HHS, DOL, Treasury, OPM)Administrative fee reduced from $115 to $15. Batching of multiple claims now permitted to lower costs and speed resolution. New IDR Gateway centralized platform rolling out in phases.cms.gov/newsroom/press-releases/federal-rule-takes-aim-saving-taxpayer-dollars-health-care-bureaucracy-reducing-dispute-fees