IDR for podiatrists: the podiatry claim record
How podiatry and foot surgery claims fared in 2025, which settings qualify, and what the surgical codes pay.
Disputes filed by podiatrists and foot and ankle surgeons grew from 483 in 2024 to 1,628 in 2025, and providers won 90.6 percent. The record is built on surgical codes such as hammertoe correction and bunion repair, billed almost entirely at surgery centers and hospitals. New York and New Jersey produced 86.12 percent of the disputes, and three filer domains brought 93.55 percent. This site explains which podiatry claims qualify, what the surgical codes pay, and where the volume sits, based only on the published files.
All 3.39 million federal IDR disputes published by CMS, 2023 through 2025. Explore the data at idrexplorer.com.
Federal IDR is the No Surprises Act arbitration process for out-of-network claims. Disputes filed by podiatrists and foot and ankle surgeons reached it 1,628 times in 2025, and providers won 90.6 percent. A podiatry claim qualifies when the care is at an in-network hospital, hospital outpatient department, or surgery center, or is emergency care, and the patient did not sign a notice and consent form. A podiatry office is not a covered facility, and only 5 disputes in the files list one. Foot surgery codes decided at medians of $24,000.00 to $35,250.00 against QPAs of $300.66 to $624.48.
Disputes grew 3.37 times in a year
Disputes filed by podiatrists and foot and ankle surgeons numbered 20 in 2023, 483 in 2024, and 1,628 in 2025, which is 3.37 times the year before. Quarterly volume rose from 65 in the first quarter of 2024 to 230 in the fourth, then ran 220, 350, 545, and 513 through 2025. Providers won 95.0 percent of disputes in 2023, 94.2 in 2024, and 90.6 in 2025 (90.01 percent leaving out default decisions). The median time to a decision was 33 days in 2024 and 29 in 2025. Of the 2025 disputes, 15.79 percent ended in default decisions, where one side never submitted an offer, against 14.49 percent in 2024. Without defaults, providers asked a median of 53.44 times the QPA while plans offered a median of 1.0 times, and the winning offers across all disputes were a median of 50.7 times. That makes the group 0.075 percent of the 2,180,938 disputes in the 2025 files.
Foot surgery codes drive the record
Hammertoe correction (28285) appears in 223 disputes and providers won 95.52 percent of them. A bunion repair with a distal metatarsal osteotomy (28296) appears in 99, a bunion repair with a double osteotomy (28299) in 64, and a metatarsal osteotomy (28308) in 51. Hospital work follows: subsequent hospital care (99232) appears in 61 disputes and its lower-level code (99231) in 28, and an emergency department visit (99284) in 35. Wound debridement (11042 for subcutaneous tissue, 11043 for muscle, and 11044 for bone) appears in 31, 42, and 27 disputes, removal of a deep implant (20680) in 41, and ankle arthroscopy with extensive debridement (29898) in 34. A dispute averages 1.15 lines, 1,870 in all.
Filers are concentrated in New York and New Jersey
Three filer domains brought 1,523 of the 1,628 disputes (93.55 percent), and practices with fewer than 20 employees filed 1,557 (95.6 percent). New York produced 885 disputes (54.4 percent), New Jersey 517 (31.8), California 120 (7.4), and Missouri 56 (3.4), so New York and New Jersey together produced 1,402 (86.12 percent). Winning offers ran at a median of 51.48 times the QPA in New York and 38.14 in New Jersey, against 58.86 in California and 68.25 in Missouri. Aetna was the plan in 425 disputes (26.1 percent; providers won 90.8), Anthem in 280 (93.9 won), UnitedHealthcare in 271 (85.2), MultiPlan in 178 (94.4), and EmblemHealth in 164 (90.9, with 51.2 percent ending in default decisions).
Plan types and the cost of filing
Self-insured employer plans accounted for 1,087 disputes (66.8 percent; 90.9 percent won), non-federal government plans for 256 (15.7 percent; 85.2 won), and fully insured group plans for 213 (13.1 percent; 93.4 won), where 25.4 percent ended in default decisions. New York and New Jersey both have a process of their own for fully insured plans, so the federal files lean toward self-insured ones. Each side pays a $15 administrative fee per dispute, and whoever wins gets the IDR entity's fee back. Lido IDR then files for a flat fee per arbitration, setting each offer from the decided foot surgery results at idrexplorer.com.
Common questions
Can podiatry claims use federal IDR?
Yes, for out-of-network podiatrists and foot and ankle surgeons at an in-network hospital, hospital outpatient department, or surgery center, and for emergency care, under plans the federal process covers. A podiatrist's scheduled surgery can lose the protection once the patient has signed a notice and consent form, and a podiatry office is not a covered facility. The process also excludes anything paid by Medicare, Medicare Advantage, Medicaid, or TRICARE.
What do foot surgery codes pay in federal IDR?
In the 2025 files, hammertoe correction (28285) had a median QPA of $300.66 and a median decided award of $24,000.00 across 280 lines that report a QPA and offers, and a bunion repair with a double osteotomy (28299) $378.87 and $35,250.00 across 73.
Why do so few filers account for the podiatry record?
Three filer domains brought 1,523 of the 1,628 disputes in 2025 (93.55 percent), and New York and New Jersey produced 86.12 percent. The count shows who files, not how many podiatry claims are underpaid.
How long does a podiatry dispute take to decide?
The median podiatry dispute in the 2025 files reached a decision in 29 days, against 33 days in 2024. Default decisions, where one side never submitted an offer, came to 15.79 percent of disputes.
What does filing cost a podiatry practice?
The $15 administrative fee is charged to each party on every dispute, and the IDR entity's fee is paid up front and goes back to the winner. A billing partner paid a share of the recovery earns more as the award grows, and foot surgery awards run to five figures. Lido IDR files for a flat fee per arbitration, which fits practices that have only a few high-value surgical claims.
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