IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 73200: Federal IDR outcomes

CT scan of arm without contrast

In 2025 Q1–Q4, the provider or facility offer prevailed in 89.9% of 1,371 determined Federal IDR dispute line items for CPT 73200. The median prevailing offer was 4.46x the QPA (25th–75th percentile 2.87x–6.38x; n = 1,242). The median time to a decision was 37 business days (n = 1,371).

Determined line items

1,371

2025 Q1–Q4 · 2 split decisions excluded

Provider win rate

89.9%

n = 1,371 · 2025 Q1–Q4

Median payment vs QPA

4.46x

middle half 2.87x–6.38x · n = 1,242 · 2025 Q1–Q4

Median days to decision

37

business days, from dispute initiation · n = 1,371 · 2025 Q1–Q4

Dollar amounts

Total awarded

$923,820

sum of prevailing offers · n = 915 · 2025 Q1–Q4

Total QPA

$186,252

sum of QPAs, same line items · n = 915 · 2025 Q1–Q4

Awarded above QPA

$737,567

total awarded minus total QPA · n = 915 · 2025 Q1–Q4

Median award per line item

$414

mean $1,010 · n = 915 · 2025 Q1–Q4

Median QPA

$85

per line item · n = 915 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

4.96x

total awarded ÷ total QPA · n = 915 · 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–Q4915$923,820$186,252$737,567$414$854.96x
2024 Q3–Q4360$136,309$27,896$108,414$359$614.89x
2024 Q3–2025 Q41,275$1.1M$214,148$845,981$395$724.95x
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–Q41,37189.9%4.46x2.87x–6.38x1,24237
2024 Q1–Q463690.3%5.12x3.97x–6.83x60570
2023 Q1–Q48687.2%3.75x3.12x–5.14x8363.5
2023 Q1–2025 Q42,09389.9%4.80x3.24x–6.65x1,930not 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
Texas90389.6%4.97x80936
Arizona14791.2%4.15x13645
New York8097.5%4.38x8087
Florida5991.5%2.57x5735
Indiana5388.7%4.72x5332

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
Texas572$473,190$414$824.42x
Arizona104$55,816$395$765.33x
New Jersey56$21,270$395$903.91x
New York56$21,270$395$903.91x
Pennsylvania56$21,270$395$903.91x

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
Radiology94093.4%4.38x93844
Emergency medicine and emergency departments31085.5%6.55x26028
Not reported / unspecified7163.4%–1128
Hospitals and facilities4887.5%2.76x3135

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 73200?

In 2025 Q1–Q4, the provider or facility offer was selected in 89.9% of 1,371 determined dispute line items for CPT 73200. 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 73200?

In 2025 Q1–Q4, the median prevailing offer was 4.46x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.87x to 6.38x (n = 1,242 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 73200?

In 2025 Q1–Q4, the median was 37 business days (n = 1,371 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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