IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 01939: Federal IDR outcomes

Anesthesia for nerve destruction procedures on spine or spinal cord of neck or upper back accessed through skin using imaging guidance

In 2025 Q1–Q4, the provider or facility offer prevailed in 83.1% of 1,093 determined Federal IDR dispute line items for CPT 01939. The median prevailing offer was 13.85x the QPA (25th–75th percentile 3.37x–34.09x; n = 889). The median time to a decision was 30 business days (n = 1,093).

Determined line items

1,093

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

83.1%

n = 1,093 · 2025 Q1–Q4

Median payment vs QPA

13.85x

middle half 3.37x–34.09x · n = 889 · 2025 Q1–Q4

Median days to decision

30

business days, from dispute initiation · n = 1,093 · 2025 Q1–Q4

Dollar amounts

Total awarded

$4.7M

sum of prevailing offers · n = 753 · 2025 Q1–Q4

Total QPA

$276,840

sum of QPAs, same line items · n = 753 · 2025 Q1–Q4

Awarded above QPA

$4.4M

total awarded minus total QPA · n = 753 · 2025 Q1–Q4

Median award per line item

$5,970

mean $6,184 · n = 753 · 2025 Q1–Q4

Median QPA

$322

per line item · n = 753 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

16.82x

total awarded ÷ total QPA · n = 753 · 2025 Q1–Q4

Dollar amounts come from the separate CMS “QPA and Offers” file: line items decided for the provider or the plan with a non-suppressed QPA and prevailing offer. That file cannot be joined to the line items above, so its n differs. Awarded = the prevailing (selected) offer; it is not a record of what was paid. State comes from the file’s geographic region; a metro area that spans states counts in each. How the dollar figures work

Dollar amounts by period

PeriodLine items with $Total awardedTotal QPAAbove QPAMedian awardMedian QPAAward ×QPA ($-weighted)
2025 Q1–Q4753$4.7M$276,840$4.4M$5,970$32216.82x
2024 Q3–Q492$443,339$29,629$413,710$5,970$32914.96x
2024 Q3–2025 Q4845$5.1M$306,468$4.8M$5,970$32216.64x
2023 Q1–2024 Q2Not available (see methodology).

From the CMS QPA and Offers file (see above). Award ×QPA here is total awarded ÷ total QPA, so large claims weigh more than in the per-line median ratio.

By period

PeriodLine itemsWin %Median ×QPA25th–75thRatio nMedian days
2025 Q1–Q41,09383.1%13.85x3.37x–34.09x88930
2024 Q1–Q418783.4%9.09x2.35x–18.03x16637
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q41,28783.2%13.06x3.13x–29.39x1,062not pooled

Line items = determined dispute line items (n). Win rate excludes split decisions and includes default decisions. Ratio n = line items reporting a payment-to-QPA ratio. Days are business days as reported by CMS (2023–2024: from IDR entity assignment; 2025: from initiation) and are never pooled.

By state

State (place of service)Line itemsWin %Median ×QPARatio nMedian days
Arizona48784.6%25.32x †48626
New Jersey24784.2%11.90x8533
Texas16487.2%6.69x13633.5
Florida8783.9%2.45x7630
Louisiana6056.7%9.25x6088

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

Dollar amounts by state

State (region)Line items with $Total awardedMedian awardMedian QPAAward ×QPA
Arizona459$3.6M$5,970$29025.94x
New Jersey94$405,996$3,790$5845.99x
New York94$405,996$3,790$5845.99x
Pennsylvania94$405,996$3,790$5845.99x
Texas81$298,241$2,464$3228.12x
Louisiana50$58,510$1,407$1646.80x

2025 Q1–Q4 · CMS QPA and Offers file · rows with n ≥ 30 line items with dollar amounts · sorted by n · Award ×QPA = total awarded ÷ total QPA.

By specialty

Specialty groupLine itemsWin %Median ×QPARatio nMedian days
Anesthesiology1,05283.2%14.56x85930
Pain medicine3384.8%–2822

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

Section: Anesthesia (00100–01999)

FAQ

What is the Federal IDR provider win rate for CPT 01939?

In 2025 Q1–Q4, the provider or facility offer was selected in 83.1% of 1,093 determined dispute line items for CPT 01939. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.

How do Federal IDR payments compare with the QPA for CPT 01939?

In 2025 Q1–Q4, the median prevailing offer was 13.85x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.37x to 34.09x (n = 889 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.

How long do Federal IDR decisions take for CPT 01939?

In 2025 Q1–Q4, the median was 30 business days (n = 1,093 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

How to Utilize IDR