IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 73070: Federal IDR outcomes

X-ray of elbow, 2 views

In 2025 Q1–Q4, the provider or facility offer prevailed in 85.9% of 1,478 determined Federal IDR dispute line items for CPT 73070. The median prevailing offer was 4.87x the QPA (25th–75th percentile 2.68x–8.26x; n = 1,282). The median time to a decision was 40 business days (n = 1,478).

Determined line items

1,478

2025 Q1–Q4 · 1 split decisions excluded

Provider win rate

85.9%

n = 1,478 · 2025 Q1–Q4

Median payment vs QPA

4.87x

middle half 2.68x–8.26x · n = 1,282 · 2025 Q1–Q4

Median days to decision

40

business days, from dispute initiation · n = 1,478 · 2025 Q1–Q4

Dollar amounts

Total awarded

$207,925

sum of prevailing offers · n = 882 · 2025 Q1–Q4

Total QPA

$56,763

sum of QPAs, same line items · n = 882 · 2025 Q1–Q4

Awarded above QPA

$151,163

total awarded minus total QPA · n = 882 · 2025 Q1–Q4

Median award per line item

$73

mean $236 · n = 882 · 2025 Q1–Q4

Median QPA

$11

per line item · n = 882 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

3.66x

total awarded ÷ total QPA · n = 882 · 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–Q4882$207,925$56,763$151,163$73$113.66x
2024 Q3–Q4338$39,364$20,838$18,526$70$91.89x
2024 Q3–2025 Q41,220$247,290$77,601$169,689$70$103.19x
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–Q41,47885.9%4.87x2.68x–8.26x1,28240
2024 Q1–Q453790.7%7.41x3.31x–8.74x49982
2023 Q1–Q43889.5%3.23x3.23x–3.23x3455
2023 Q1–2025 Q42,05387.2%5.27x2.72x–8.63x1,815not 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
Texas70484.4%4.60x62439
Arizona17889.3%7.13x15861.5
New York8890.9%6.15x88133
Tennessee8576.5%1.25x5541
Oklahoma7194.4%5.46x7130
Florida6195.1%2.72x6144
Indiana6182.0%6.29x6149
Arkansas4092.5%7.59x3937
New Mexico3196.8%6.03x3130

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
Texas372$60,720$73$103.31x
Arizona125$15,853$70$106.33x
New Jersey73$7,893$70$119.49x
New York73$7,893$70$119.49x
Pennsylvania73$7,893$70$119.49x
Arkansas64$14,610$212$1491.23x
Mississippi64$14,610$212$1491.23x
Tennessee64$14,610$212$1491.23x

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
Radiology83689.8%5.26x83654.5
Emergency medicine and emergency departments35788.2%5.78x32129
Hospitals and facilities17582.9%1.35x9536
Not reported / unspecified10752.3%–2731

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

Section: Radiology (70010–79999)

FAQ

What is the Federal IDR provider win rate for CPT 73070?

In 2025 Q1–Q4, the provider or facility offer was selected in 85.9% of 1,478 determined dispute line items for CPT 73070. 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 73070?

In 2025 Q1–Q4, the median prevailing offer was 4.87x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.68x to 8.26x (n = 1,282 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 73070?

In 2025 Q1–Q4, the median was 40 business days (n = 1,478 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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