NSA · Federal IDR
NSA IDR for surgical practices. Built for your specialty, not a generalist shop.
- Surgeon founded
- HIPAA compliant · BAA on request
- One claim per CPT at federal IDR
Tier 1: Download the NSA IDR checklist before you file.
Download the NSA IDR checklistOrthopedic Surgery NSA IDR
Orthopedic surgery generates some of the highest volumes of NSA IDR disputes in the federal system. CPT codes are procedure specific, laterality dependent, and modifier sensitive.
CPT 27447 (total knee arthroplasty) and 27446 (hemicondylar replacement) are not interchangeable. A bilateral modifier changes the payment calculation. A staged procedure filed without the correct modifier triggers an eligibility challenge before arbitration begins.
Typical claim range: $2,000 to $8,000 per CPT. Confirmed on your free review.
Full orthopedic pageGet a free IDR review for your orthopedic practiceNeurosurgery NSA IDR
Neurosurgery produces some of the highest per case IDR dispute amounts in the federal system. Kronos Revenue was built by Dr. John M. Abrahams, a board certified practicing neurosurgeon.
Neurosurgical CPT coding involves add on codes, intraoperative procedure codes, and staged billing structures. A generalist who batches CPT 61510 with 61517 into one IDR submission has created an unfiled claim for the chemotherapy implantation.
Typical claim range: $5,000 to $25,000 per CPT for major cranial procedures.
Full neurosurgery pageGet a free IDR review for your neurosurgery practiceSpine Surgery NSA IDR
Spine surgery is the specialty most actively using the NSA IDR system, and the specialty where batched CPT filings cause the most damage.
A multi level lumbar fusion involves CPT 22612, 22632, 22840, and 63030. Those are four separately eligible IDR claims. An attorney who batches them into one submission creates a composite offer that does not match any prior determination cleanly.
Typical claim range: $4,000 to $15,000 per CPT. Multi level fusion cases can generate $40,000 or more in total IDR eligible disputed amounts from a single surgery.
Full spine pageGet a free IDR review for your spine surgery groupPlastic Surgery NSA IDR
Reconstructive procedures are frequently coded as cosmetic by insurers unfamiliar with the clinical distinction.
Getting an arbitrator to understand why a complex free flap reconstruction bills at $18,000 requires documentation that explains the procedure, the clinical necessity, and the market benchmark for that specific technique.
Typical claim range: $3,000 to $12,000 per CPT for primary reconstruction.
Full plastic surgery pageGet a free IDR review for your plastic surgery practiceAnesthesia NSA IDR
Anesthesia NSA IDR has specific rules that differ from surgical specialty filing. Anesthesia claims bill on base units plus time units.
Federal IDR rules currently permit anesthesia services under the same CPT code to be bundled. Rules on bundling across related CPT codes remain under active regulatory development. Kronos Revenue files anesthesia claims under current regulatory requirements, not assumptions about what the rules will become.
Typical claim range: $800 to $4,000 per CPT depending on case length and base units.
Full anesthesia pageGet a free IDR review for your anesthesia groupGeneral Surgery NSA IDR
General surgery out of network claims at in network ASCs and hospitals are systematically underpaid and systematically winnable at IDR when filed correctly.
Kronos Revenue applies the same one CPT per claim standard to general surgery that it applies to neurosurgery and orthopedics.
Typical claim range: $1,500 to $6,000 per CPT.
Full general surgery pageGet a free IDR review for your general surgery practiceMedical review
Questions about specialty NSA IDR
- Which surgical specialties does Kronos Revenue support for NSA IDR?
- We support orthopedic, neurosurgery, spine, plastic, anesthesia, and general surgery practices. Every federal IDR submission is one claim per CPT, specialty coded by RCM specialists trained on your procedure set.
- Why does specialty coding matter at federal IDR?
- Arbiters expect operative detail and correct CPT separation. Generalist attorneys batch codes, which violates federal IDR rules and loses awards your practice earned. We file each eligible CPT individually.
- Can Kronos handle high value neurosurgery and spine claims?
- Yes. Kronos was founded by a board certified neurosurgeon. Complex cranial, spine, and instrumentation claims receive the clinical depth IDR requires, not boilerplate attorney letters.
- What is a typical claim range by specialty?
- Ranges vary by CPT and market. Orthopedic claims often fall between $2,000 and $8,000 per CPT; neurosurgery and spine claims can run higher. We confirm estimates on your free case review using real EOBs.
- How do I get a free NSA IDR review for my specialty?
- Submit the case review form or call (914) 705 6830. Share sample EOBs and your specialty mix. We respond within one business day with what you could recover versus your current attorney or biller.
References
- CMS Federal IDR Q1/Q2 2025 Public Use File (January 21, 2026)
- Georgetown University CHIR · Health Affairs webinar, March 2026
- Brookings Institution NSA Arbitration Databook · April 2026
- ACR — Providers prevail in vast majority of IDR claims · January 29, 2026
- Zelis — NSA IDR eligibility challenges · March 2026
- No Surprises Act: Public Law 116-260, Division BB, Title I
- Federal IDR regulations: 45 CFR Part 149
- CMS No Surprises Act overview
- Federal IDRE portal
Explore more on Kronos Revenue
Get a free NSA IDR review for your specialty
- Surgeon founded
- HIPAA compliant · BAA on request
- One claim per CPT at federal IDR