This estimate reports the historical public record for similar disputes. IDRGateKit is not a party's agent, gives no advice on any dispute, and offers this tool on identical terms to providers and payers.
The estimator applies the published CMS Federal IDR Public Use File benchmarks (see /benchmarks) to a dispute line's qualifying payment amount (QPA). Federal IDR arbitration is "baseball style": the certified IDR entity awards ONE of the two parties' offers, never a split. So the expected outcome for a dispute line is a probability-weighted mix of the historical provider offer and the historical payer offer, where the weight is the historical rate at which the provider has prevailed for similar disputes (same state, service code, and, where published, the same certified IDR entity):
expected award = (provider-prevailing rate x provider offer)
+ ((1 - provider-prevailing rate) x payer offer)
Units: the provider-prevailing rate and both offers are published as percentages; an offer of "300%" means 3x the QPA. Cells with too few published disputes are suppressed in the underlying benchmarks and are never used here.
CMS administrative fee of $15 per party (effective 2026-06-11), plus a certified IDR entity fee of $425-$800 for a single dispute or $625-$1,150 for a batched dispute (2026 published range), is paid by the non-prevailing party.
Paste a data-tier API key from /benchmarks (free plan included; this page never stores or transmits your key anywhere but directly to this API).
Centers for Medicare & Medicaid Services. (2025). Federal IDR Public Use File [Data file and data dictionary]. Retrieved from https://www.cms.gov/nosurprises/policies-and-resources/reports