IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 30000: Federal IDR outcomes

Drainage of abscess or blood accumulation of nose

In 2025 Q1–Q4, the provider or facility offer prevailed in 74.2% of 62 determined Federal IDR dispute line items for CPT 30000. The median time to a decision was 23 business days (n = 62).

Determined line items

62

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

74.2%

n = 62 · 2025 Q1–Q4

Median payment vs QPA

–

n = 26, below 30 · 2025 Q1–Q4

Median days to decision

23

business days, from dispute initiation · n = 62 · 2025 Q1–Q4

Dollar amounts

Fewer than 30 line items with dollar amounts in 2025 Q1–Q4; not shown.

Dollar amounts by period

PeriodLine items with $Total awardedTotal QPAAbove QPAMedian awardMedian QPAAward ×QPA ($-weighted)
2025 Q1–Q4Fewer than 30 line items with dollar amounts; not shown.
2024 Q3–Q4Fewer than 30 line items with dollar amounts; not shown.
2024 Q3–2025 Q4Fewer than 30 line items with dollar amounts; not shown.
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–Q46274.2%––2623
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q46274.2%––26not 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
Texas5377.4%–2424

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

By specialty

No row has 30 or more determined line items in 2025 Q1–Q4.

Section: Surgery (10004–69990)

FAQ

What is the Federal IDR provider win rate for CPT 30000?

In 2025 Q1–Q4, the provider or facility offer was selected in 74.2% of 62 determined dispute line items for CPT 30000. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.

How long do Federal IDR decisions take for CPT 30000?

In 2025 Q1–Q4, the median was 23 business days (n = 62 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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