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Scope & methodology
CPT 10004–69990, across reported care settings.
This broad range includes minor procedures and major operations. It does not isolate surgical assistants, facility fees, or orthopedic surgery. Code categories overlap other sections and must not be added together.
- Quarter: the published determination quarter, which may differ from the service date. This snapshot covers 2023 Q1–2025 Q4.
- Lines: reported outcome service lines, including components and defaults; not unique patients, disputes, or procedures. Zero lines means no matching outcome rows in this snapshot.
- NPIs: distinct reported identifiers matching a 10-digit NPI format. Missing and malformed identifiers are excluded. These are not verified groups and cannot be added across codes or quarters.
- Win %: provider wins divided by provider plus insurer wins. Other or unknown winners are excluded. “Exclude defaults” restricts this rate to records explicitly marked non-default; it does not change the award sample.
- Payouts: selected awards from the independent anonymous financial sample, not confirmed collections or additional payments. Missing, suppressed, negative, and invalid awards are excluded; zero awards and duplicate-looking rows are retained. Components and unknown line types are excluded where line type is published; older files without that field are retained.
- Financial sample: mean, median, and continuous 25th–75th percentiles use usable awards from both winning sides, including defaults. Awards may cover bundles and are not per-unit prices. Hover over an amount or open a code to see sample sizes. Small samples may be unstable. “Middle 50%” sorts by the lower endpoint.
- Code scope: CPT ranges include CPT-labeled records and older records where code type was not published. HCPCS entries are included only where explicitly labeled and supported by this section. Missing or conflicting code-type labels are excluded. Descriptions are reported CMS text, using the latest available description, and are not independently verified clinical guidance.
- Separate samples: outcomes and dollars are aggregated independently by code and quarter. No row-level join or attribution of awards to named providers is made. A code may appear only in the financial sample; an unavailable award remains —, never a zero-dollar imputation.
- Overlapping sections: services may appear in more than one section, especially Surgery, Orthopedics, and ASC setting. Do not add section totals.