IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 73552: Federal IDR outcomes

X-ray of thigh bone, minimum 2 views

In 2025 Q1–Q4, the provider or facility offer prevailed in 90.4% of 2,082 determined Federal IDR dispute line items for CPT 73552. The median prevailing offer was 8.44x the QPA (25th–75th percentile 3.43x–10.76x; n = 1,901). The median time to a decision was 47 business days (n = 2,082).

Determined line items

2,082

2025 Q1–Q4 · 2 split decisions excluded

Provider win rate

90.4%

n = 2,082 · 2025 Q1–Q4

Median payment vs QPA

8.44x

middle half 3.43x–10.76x · n = 1,901 · 2025 Q1–Q4

Median days to decision

47

business days, from dispute initiation · n = 2,082 · 2025 Q1–Q4

Dollar amounts

Total awarded

$387,885

sum of prevailing offers · n = 1,482 · 2025 Q1–Q4

Total QPA

$63,603

sum of QPAs, same line items · n = 1,482 · 2025 Q1–Q4

Awarded above QPA

$324,281

total awarded minus total QPA · n = 1,482 · 2025 Q1–Q4

Median award per line item

$111

mean $262 · n = 1,482 · 2025 Q1–Q4

Median QPA

$12

per line item · n = 1,482 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

6.10x

total awarded ÷ total QPA · n = 1,482 · 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–Q41,482$387,885$63,603$324,281$111$126.10x
2024 Q3–Q4609$77,564$13,101$64,463$105$115.92x
2024 Q3–2025 Q42,091$465,449$76,704$388,745$105$126.07x
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–Q42,08290.4%8.44x3.43x–10.76x1,90147
2024 Q1–Q485593.2%9.19x5.78x–11.02x82375
2023 Q1–Q444100.0%3.21x3.21x–9.35x4170
2023 Q1–2025 Q42,98191.4%8.62x4.17x–10.76x2,765not 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
Texas1,24290.7%9.59x1,15047
Arizona28591.6%8.57x26254
Florida10097.0%2.62x10044
Indiana9487.2%7.07x9445
New York8693.0%9.94x86101
Tennessee5088.0%1.85x3759.5
California3894.7%–1444

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
Texas782$139,190$130$125.15x
Arizona208$105,219$105$1228.33x
New Jersey71$6,530$105$118.20x
New York71$6,530$105$118.20x
Pennsylvania71$6,530$105$118.20x
Indiana40$18,738$113$173.93x
Arkansas34$9,761$287$1671.92x
Mississippi34$9,761$287$1671.92x
Tennessee34$9,761$287$1671.92x
Florida32$1,385$43$172.94x

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
Radiology1,50993.5%8.76x1,50756
Emergency medicine and emergency departments30486.8%6.98x25326
Hospitals and facilities17688.6%2.44x10848
Not reported / unspecified8350.6%–2331

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 73552?

In 2025 Q1–Q4, the provider or facility offer was selected in 90.4% of 2,082 determined dispute line items for CPT 73552. 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 73552?

In 2025 Q1–Q4, the median prevailing offer was 8.44x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.43x to 10.76x (n = 1,901 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 73552?

In 2025 Q1–Q4, the median was 47 business days (n = 2,082 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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