What are the biggest vein codes in federal IDR?

Radiofrequency ablation (36475, 2,426 disputes in 2025), foam sclerotherapy (36465, 799 disputes), and tunneled venous access ports (36561, 670 disputes). The ablation and sclerotherapy lines paid median decided awards of $43,500 and $41,500.

What is the win rate on vein and vascular claims?

Ablation lines won 82.2 percent of decided 2025 disputes and sclerotherapy 84.4 percent. Across the 2023 through 2025 record, vascular surgery line items won 88.6 percent of 4,089 disputes.

Why are vein ablation awards so much higher than the QPA?

The QPA is the payer's median contracted rate, and contracted rates for office-heavy vein codes run in the hundreds. Arbitrators price the specific case on its merits, and in 2025 they put the median decided ablation line at $43,500.

Answers / The vein record

The vein clinic IDR record

In the 2025 public use files, endovenous radiofrequency ablation (36475) appeared in 2,426 federal IDR disputes. Providers won 82.2 percent, and the median decided award was $43,500 against a median QPA of $571.24. Foam sclerotherapy (36465) paid a median of $41,500 against $253.93. Across 2023 through 2025, vascular surgery line items won 88.6 percent of 4,089 disputes with a $36,000 median award.

The ablation lines

Endovenous radiofrequency ablation of an incompetent truncal vein, code 36475, is the center of the published vein record under the No Surprises Act. It appeared in 2,426 disputes in 2025. Providers won 82.2 percent of decided ones. The median QPA, the payer's benchmark, was $571.24; the median decided award was $43,500, a multiple above 70. Arbitrators looked at the same lines payers priced in the hundreds and valued them in the tens of thousands, case after case, in a published federal dataset anyone can check.

Sclerotherapy ran even wider

Ultrasound-guided foam sclerotherapy, code 36465, appeared in 799 disputes with an 84.4 percent win rate. Its median QPA was $253.93 and its median decided award was $41,500, a multiple above 150 and one of the widest spreads of any procedure code in the files. Venous access work rounds out the picture: tunneled central venous port insertion (36561) won 91.7 percent of its 670 decided disputes.

The broader vascular record

Zooming out from vein-specific codes, the 2023 through 2025 record contains 4,089 disputes with vascular surgery line items. Providers won 88.6 percent of decisions and the median decided award was $36,000, the third largest of any surgical specialty in the published files. Vascular work that reaches arbitration wins at high rates and large sizes, whether it arrived through an emergency consult, a bypass at an in-network hospital, or an ablation at an ASC.

One state carries the volume

The striking feature of the vein record is its geography: most of the published ablation volume traces to a concentrated set of New Jersey filers. A vein practice in Texas, Florida, or Arizona reading these numbers is usually reading the record of someone else's claims. The published medians at idrexplorer.com are national evidence available to any filer, and in most states nobody has picked them up. Lido IDR builds each offer from the matching decided awards and files for a flat fee per arbitration.

Put your ablation book next to the record

For vein and ablation claims, Lido IDR sets each offer from decided awards on the same codes against the same payers, then files for a flat fee per arbitration. Talk to an IDR specialist.