IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 49083: Federal IDR outcomes

Drainage of fluid from abdominal cavity using imaging guidance

In 2025 Q1–Q4, the provider or facility offer prevailed in 91.4% of 1,806 determined Federal IDR dispute line items for CPT 49083. The median prevailing offer was 5.87x the QPA (25th–75th percentile 3.30x–8.66x; n = 1,768). The median time to a decision was 41 business days (n = 1,806).

Determined line items

1,806

2025 Q1–Q4 · 4 split decisions excluded

Provider win rate

91.4%

n = 1,806 · 2025 Q1–Q4

Median payment vs QPA

5.87x

middle half 3.30x–8.66x · n = 1,768 · 2025 Q1–Q4

Median days to decision

41

business days, from dispute initiation · n = 1,806 · 2025 Q1–Q4

Dollar amounts

Total awarded

$1.5M

sum of prevailing offers · n = 1,471 · 2025 Q1–Q4

Total QPA

$254,761

sum of QPAs, same line items · n = 1,471 · 2025 Q1–Q4

Awarded above QPA

$1.3M

total awarded minus total QPA · n = 1,471 · 2025 Q1–Q4

Median award per line item

$1,255

mean $1,041 · n = 1,471 · 2025 Q1–Q4

Median QPA

$146

per line item · n = 1,471 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

6.01x

total awarded ÷ total QPA · n = 1,471 · 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–Q41,471$1.5M$254,761$1.3M$1,255$1466.01x
2024 Q3–Q4835$722,675$120,529$602,146$911$1376.00x
2024 Q3–2025 Q42,306$2.3M$375,290$1.9M$1,141$1416.01x
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–Q41,80691.4%5.87x3.30x–8.66x1,76841
2024 Q1–Q41,43189.9%6.48x3.50x–8.65x1,42672
2023 Q1–Q444874.6%2.71x1.28x–8.28x42662
2023 Q1–2025 Q43,68588.8%5.69x3.22x–8.65x3,620not 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
Texas95094.6%8.48x94742
Arizona41789.0%3.53x41146
Florida17898.3%2.98x17831
Indiana7380.8%6.63x7230
New York5383.0%5.24x5337
California3196.8%–1267

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
Texas816$963,494$1,318$1656.96x
Arizona335$267,517$428$1385.46x
Florida92$47,318$519$1763.13x
New York31$29,325$1,255$1784.76x

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
Radiology1,66392.8%6.58x1,66241
Hospitals and facilities6090.0%3.26x3658.5
Emergency medicine and emergency departments5276.9%3.22x3931

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

Section: Surgery (10004–69990)

FAQ

What is the Federal IDR provider win rate for CPT 49083?

In 2025 Q1–Q4, the provider or facility offer was selected in 91.4% of 1,806 determined dispute line items for CPT 49083. 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 49083?

In 2025 Q1–Q4, the median prevailing offer was 5.87x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.30x to 8.66x (n = 1,768 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 49083?

In 2025 Q1–Q4, the median was 41 business days (n = 1,806 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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