How many podiatry disputes reach federal IDR?

The 2025 files hold 1,628 disputes filed by podiatrists and foot and ankle surgeons, up from 483 in 2024 and 20 in 2023. That is 0.075 percent of the 2,180,938 disputes published for 2025, and providers won 90.6 percent of them.

How often do providers win podiatry disputes?

In 2025 providers won 90.6 percent of podiatry disputes, or 90.01 percent leaving out default decisions, down from 94.2 percent in 2024 and 95.0 percent in 2023. Hammertoe correction (28285) was won 95.52 percent of the time across 223 disputes.

Which payers appear most in podiatry disputes?

Aetna was the plan in 425 of the 1,628 disputes (26.1 percent), followed by Anthem with 280, UnitedHealthcare with 271, MultiPlan with 178, and EmblemHealth with 164. EmblemHealth disputes ended in default decisions 51.2 percent of the time.

Answers / The podiatry record

The podiatry IDR record

In the 2025 public use files, podiatrists and foot and ankle surgeons filed 1,628 disputes in federal IDR under the No Surprises Act, 3.37 times the 483 of 2024, and providers won 90.6 percent of them. The median dispute took 29 days to decide, and 15.79 percent ended in default decisions, where one side never submitted an offer. Without defaults, providers asked a median of 53.44 times the QPA while plans offered a median of 1.0 times, and winning offers came in at 50.7 times.

Volume, speed, and default decisions

Disputes filed by podiatrists and foot and ankle surgeons numbered 20 in 2023, 483 in 2024, and 1,628 in 2025, with 1,870 lines in 2025 against 515 in 2024. Quarterly volume rose through 2024 with 65, 67, 121, and 230 disputes, 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, and leaving out default decisions the rates were 92.86, 93.22, and 90.01 percent. Foot surgery codes carry the record: hammertoe correction (28285) alone appears in 223 disputes, and providers won 95.52 percent of them.

A median dispute took 20 days to decide in 2023, 33 in 2024, and 29 in 2025. Default decisions, where one side never submitted an offer, came to 30.0 percent of 2023 disputes, 14.49 percent of 2024 disputes, and 15.79 percent of 2025 disputes. Without defaults, providers asked a median of 12.12 times the QPA in 2023, 29.65 in 2024, and 53.44 in 2025, while plans offered a median of 1.0 times each year. Winning offers came in at 9.21, 27.58, and 50.7 times the QPA, so awards rose with the asks.

Payers and how their disputes ended

Aetna was the plan in 425 disputes (26.1 percent). Providers won 90.8 percent of them, 11.8 percent ended in default decisions, and winning offers ran at a median 50.55 times the QPA. Anthem was the plan in 280 (17.2 percent; 93.9 won; 5.0 percent default decisions; 59.45 times), UnitedHealthcare in 271 (16.6 percent; 85.2 won; 9.6 percent default decisions; 51.48 times), and MultiPlan in 178 (10.9 percent; 94.4 won; 66.9 times). EmblemHealth stands apart: it was the plan in 164 disputes (10.1 percent), 51.2 percent of them ended in default decisions, and winning offers ran at a median 28.42 times the QPA, the lowest of the large payers. Cigna was the plan in 29 disputes, all won by the provider, with 44.8 percent ending in default decisions.

States and plan types

New York providers won 89.3 percent of 885 disputes, with 18.6 percent ending in default decisions. New Jersey providers won 92.8 percent of 517 (15.1 percent default decisions), California providers 91.7 percent of 120 (5.0 percent), and Missouri providers 80.4 percent of 56 (5.4 percent). Providers won every Nevada dispute (23) and every Florida dispute (20), though the counts are small.

Self-insured employer plans were the plan type in 1,087 disputes (66.8 percent; 90.9 won; winning offers at 52.15 times the QPA), non-federal government plans in 256 (15.7 percent; 85.2 won; 46.33 times), and fully insured group plans in 213 (13.1 percent; 93.4 won; 44.98 times). Fully insured plans ended in default decisions 25.4 percent of the time, against 15.0 percent for self-insured plans and 10.2 percent for non-federal government plans. Federal employee plans appeared in 28 disputes (96.4 percent won) and individual-market plans in 18.

Filers and practice size

Filing is concentrated. The largest filer domain brought 1,083 disputes (66.5 percent), the second 328 (20.1 percent), and the third 112 (6.9 percent), and they won 92.0, 91.8, and 89.3 percent. A fourth domain filed 37 disputes, won 59.5 percent, and saw 62.2 percent end in default decisions. Practices with fewer than 20 employees filed 1,557 disputes (95.6 percent; 90.6 won), those with 20 to 50 employees filed 58 (3.6 percent; 94.8 won), and those with 51 to 100 employees filed 13 (69.2 percent won). Because a few filers account for almost every dispute, a podiatry median describes their claims more than the profession's. The payer and state breakdowns are on idrexplorer.com, and Lido IDR uses them to set each podiatry offer before filing for a flat fee per arbitration.

Price your foot surgery claims against the record

Lido IDR sets the offer on each foot surgery claim from what the same code decided at for similar payers in your states, and files for a flat fee per arbitration. Talk to an IDR specialist.