Federal IDR outcomes by CPT code
One page for each CPT code with at least 30 determined dispute line items in 2023 Q1–2025 Q4 (1,910 codes). Only line items that CMS typed as CPT are included in code-level figures.
Code sections
- Anesthesia (00100–01999) 184 codes
- Surgery (10004–69990) 954 codes
- Radiology (70010–79999) 301 codes
- Pathology and laboratory (80047–89398) 242 codes
- Evaluation and management (99202–99499) 55 codes
- Medicine (90281–99607, excluding E/M) 165 codes
- Category III (emerging technology, ending in T) 2 codes
- Proprietary laboratory analyses (ending in U) 7 codes
Most disputed codes
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 99284 Emergency department visit with moderate level of medical decision making | 1,466,249 | 84.0% | 3.10x | 1,337,107 | – |
| 99285 Emergency department visit with high level of medical decision making | 909,151 | 83.2% | 2.85x | 801,298 | – |
| 99283 Emergency department visit with low level of medical decision making | 409,835 | 82.2% | 3.28x | 371,848 | – |
| 71045 X-ray of chest, 1 view | 197,547 | 90.3% | 6.58x | 189,552 | – |
| 74177 CT scan of abdomen and pelvis with contrast | 155,427 | 88.9% | 6.40x | 145,164 | – |
| 77067 Screening mammography | 140,460 | 94.1% | 3.10x | 139,815 | – |
| 77063 Screening 3D breast mammography | 130,342 | 94.2% | 2.57x | 129,868 | – |
| 99291 Critical care, first 30-74 minutes | 118,802 | 85.2% | 3.28x | 103,666 | – |
| 85025 Complete blood cell count (red cells, white blood cell, platelets), automated te | 114,006 | 82.6% | 4.33x | 69,117 | – |
| 70450 CT scan head or brain without contrast | 107,751 | 89.7% | 4.78x | 99,634 | – |
| 95938 Placement of skin electrodes and measurement of stimulated sites on arms and leg | 100,824 | 86.5% | 27.74x † | 85,872 | – |
| 71046 X-ray of chest, 2 views | 100,294 | 88.3% | 7.35x | 90,126 | – |
2023 Q1–2025 Q4 · rows with n ≥ 30 determined line items · sorted by n.
Codes with the most line items with dollar amounts
| CPT code | Line items with $ | Total awarded | Median award | Median QPA | Award ×QPA |
|---|---|---|---|---|---|
| 99284 Emergency department visit with moderate level of medical decision making | 1,161,936 | $2.91B | $660 | $213 | 6.02x |
| 99285 Emergency department visit with high level of medical decision making | 676,409 | $1.52B | $852 | $286 | 3.45x |
| 99283 Emergency department visit with low level of medical decision making | 304,512 | $1.26B | $979 | $169 | 10.39x |
| 71045 X-ray of chest, 1 view | 160,764 | $20.2M | $90 | $11 | 4.85x |
| 77067 Screening mammography | 121,248 | $25.0M | $192 | $65 | 3.18x |
| 74177 CT scan of abdomen and pelvis with contrast | 120,385 | $220.4M | $956 | $138 | 3.68x |
| 77063 Screening 3D breast mammography | 114,615 | $16.4M | $130 | $50 | 2.83x |
| 70450 CT scan head or brain without contrast | 85,512 | $84.2M | $360 | $61 | 4.95x |
| 99291 Critical care, first 30-74 minutes | 83,118 | $172.4M | $1,028 | $313 | 2.82x |
| 71046 X-ray of chest, 2 views | 80,356 | $26.0M | $125 | $14 | 1.89x |
| 95938 Placement of skin electrodes and measurement of stimulated sites on arms and leg | 68,741 | $271.9M | $2,020 | $57 | 8.02x |
| 85025 Complete blood cell count (red cells, white blood cell, platelets), automated te | 67,507 | $19.1M | $268 | $45 | 4.15x |
2024 Q3–2025 Q4 · CMS QPA and Offers file · rows with n ≥ 30 line items with dollar amounts · sorted by n · Award ×QPA = total awarded ÷ total QPA.