NSA · Federal IDR

Orthopedic 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. Download the NSA IDR checklist before your first filing.
Get a free NSA IDR reviewBook a consultation(914) 705 6830
  • Surgeon founded
  • HIPAA compliant · BAA on request
  • One claim per CPT at federal IDR

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.

Common Orthopedic Surgery CPT codes in NSA IDR

Knee

27447 total knee arthroplasty · 27446 hemicondylar replacement · 29881 meniscectomy medial or lateral · 29882 meniscus repair · 27570 manipulation under anesthesia

Shoulder

23412 rotator cuff repair chronic · 23420 complete rotator cuff repair · 29806 SLAP repair · 29827 biceps tenodesis · 23470 total shoulder arthroplasty unconstrained

Hip

27130 total hip arthroplasty · 27132 conversion to total hip · 27137 revision acetabular · 27138 revision femoral · 29914 hip arthroscopy femoroplasty

Typical claim range: $2,000 to $8,000 per CPT. Confirmed on your free review.

Get a free IDR review for your orthopedic practice

Medical review

Orthopedic Surgery NSA IDR questions

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

  1. CMS Federal IDR Q1/Q2 2025 Public Use File (January 21, 2026)
  2. Georgetown University CHIR · Health Affairs webinar, March 2026
  3. Brookings Institution NSA Arbitration Databook · April 2026
  4. ACR — Providers prevail in vast majority of IDR claims · January 29, 2026
  5. Zelis — NSA IDR eligibility challenges · March 2026
  6. No Surprises Act: Public Law 116-260, Division BB, Title I
  7. Federal IDR regulations: 45 CFR Part 149
  8. CMS No Surprises Act overview
  9. Federal IDRE portal

Explore more on Kronos Revenue

Get a free IDR review for your orthopedic practice

Get a free NSA IDR review(914) 705 6830
  • Surgeon founded
  • HIPAA compliant · BAA on request
  • One claim per CPT at federal IDR