NSA · Federal IDR
Plastic Surgery NSA IDR
Reconstructive procedures are frequently coded as cosmetic by insurers unfamiliar with the clinical distinction. Download the NSA IDR checklist before your first filing.
- Surgeon founded
- HIPAA compliant · BAA on request
- One claim per CPT at federal IDR
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.
Common Plastic Surgery CPT codes in NSA IDR
Reconstruction
19364 breast reconstruction free flap · 19368 TRAM reconstruction · 15756 free muscle flap · 15757 free skin flap with microvascular anastomosis
Hand and microsurgery
25447 wrist arthroplasty · 26115 excision tendon sheath tumor · 26356 flexor tendon repair · 64716 nerve decompression hand
Typical claim range: $3,000 to $12,000 per CPT for primary reconstruction.
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Plastic 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
- 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 IDR review for your plastic surgery practice
- Surgeon founded
- HIPAA compliant · BAA on request
- One claim per CPT at federal IDR