What IONM and Neurodiagnostics teams should benchmark
IONM and Neurodiagnostics IDR outcomes are shaped by code mix. The same payer can look fair in one lane and misaligned in another. Start with the codes that dominate your disputed claims, then compare state and payer behavior.
The purpose of this page is to help a specialty leader or RCM team decide where the federal IDR data supports a closer claim-level review.
Top IONM and Neurodiagnostics service codes
| Code | Service | Disputes | Provider win rate | Median award | Median award dollars |
|---|---|---|---|---|---|
| 95938 | Short-latency somatosensory evoked potential study, stimulation of any/all... | 55,067 | 84.6% | 49.3x | $2,800 |
| 95941 | Continuous intraoperative neurophysiology monitoring, from outside the operating... | 36,657 | 85.3% | 14.3x | $5,325 |
| 95939 | Central motor evoked potential study (transcranial motor stimulation); in upper and... | 30,795 | 83.9% | 21.3x | $2,860 |
| 95861 | Needle electromyography; 2 extremities with or without related paraspinal areas | 21,758 | 85.2% | 26.2x | $3,000 |
| 95955 | Electroencephalogram (EEG) during nonintracranial surgery (eg, carotid surgery) | 17,514 | 86.6% | 48.3x | $5,100 |
| 95937 | Neuromuscular junction testing with repetitive nerve stimulation | 16,493 | 86.7% | 76.7x | $6,225 |
| G0453 | Continuous intraoperative neurophysiology monitoring (IONM), from outside the... | 13,145 | 78% | 17.5x | $3,588 |
| 95870 | Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial)... | 12,816 | 83% | 124x | $4,800 |
Top states for IONM and Neurodiagnostics disputes
| State | Disputes | Provider win rate | Median award |
|---|---|---|---|
| Texas | 39,734 | 89.3% | 70.4x |
| Florida | 14,701 | 86.1% | 20.2x |
| Ohio | 12,337 | 79.1% | 92.2x |
| New Jersey | 12,040 | 82.9% | 39.5x |
| Pennsylvania | 6,807 | 84.1% | 17.9x |
| New York | 6,362 | 82.7% | 39.9x |
| Arizona | 6,263 | 82.4% | 45.4x |
| Colorado | 6,087 | 81.4% | 27.1x |
Top payers in IONM and Neurodiagnostics
| Payer | Disputes | Provider win rate | Median award |
|---|---|---|---|
| BCBSTX | 43,852 | 93.9% | 59.4x |
| UnitedHealthcare | 28,371 | 77% | 27.3x |
| Anthem Blue Cross | 22,487 | 82.6% | 67.8x |
| Cigna / MultiPlan | 13,082 | 77.6% | 34.9x |
| Aetna | 9,982 | 88.8% | 22.5x |
| Florida Blue | 9,469 | 92.7% | 16.9x |
| UMR | 8,708 | 81.2% | 21.5x |
| Cigna (cigna.com) | 2,761 | 77.7% | 6.6x |
Open the IONM and Neurodiagnostics dashboard
Filter the live explorer by state, payer, and year to compare IONM and Neurodiagnostics outcomes against your own claim mix.
FAQ
How many IONM and Neurodiagnostics federal IDR disputes are in the dataset?
This benchmark shows 165,409 IONM and Neurodiagnostics disputes.
What is the IONM and Neurodiagnostics provider win rate?
The non-default provider win rate is 84.7%.
What should IONM and Neurodiagnostics groups compare first?
Start with service-code mix, then narrow by payer and state. That sequence usually gives a more useful answer than a national specialty average.
Related benchmarks
Sources and method
- CMS: Federal IDR reports and public use files
- CMS: About Independent Dispute Resolution
- CMS: Federal IDR timeline for claims
Data source: CMS Federal IDR public use files, coverage through 2025Q4; data build 2026-09-21. Counts are CMS dispute counts unless a table says line items. Win rates labeled non-default exclude payer no-show defaults. Award multiples are medians versus QPA. Dollar figures, where shown, are anchored estimates from CMS QPA-and-offer fields, not payment records. This page is informational, not legal or reimbursement advice.