IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 73720: Federal IDR outcomes

MRI scan of leg before and after contrast

In 2025 Q1–Q4, the provider or facility offer prevailed in 91.7% of 516 determined Federal IDR dispute line items for CPT 73720. The median prevailing offer was 3.38x the QPA (25th–75th percentile 2.21x–4.27x; n = 509). The median time to a decision was 46 business days (n = 516).

Determined line items

516

2025 Q1–Q4 · 1 split decisions excluded

Provider win rate

91.7%

n = 516 · 2025 Q1–Q4

Median payment vs QPA

3.38x

middle half 2.21x–4.27x · n = 509 · 2025 Q1–Q4

Median days to decision

46

business days, from dispute initiation · n = 516 · 2025 Q1–Q4

Dollar amounts

Total awarded

$189,415

sum of prevailing offers · n = 297 · 2025 Q1–Q4

Total QPA

$62,325

sum of QPAs, same line items · n = 297 · 2025 Q1–Q4

Awarded above QPA

$127,090

total awarded minus total QPA · n = 297 · 2025 Q1–Q4

Median award per line item

$510

mean $638 · n = 297 · 2025 Q1–Q4

Median QPA

$201

per line item · n = 297 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

3.04x

total awarded ÷ total QPA · n = 297 · 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–Q4297$189,415$62,325$127,090$510$2013.04x
2024 Q3–Q4200$139,635$34,081$105,554$743$1524.10x
2024 Q3–2025 Q4497$329,049$96,406$232,644$743$1853.41x
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–Q451691.7%3.38x2.21x–4.27x50946
2024 Q1–Q437089.5%4.01x3.18x–5.15x37083
2023 Q1–Q47894.9%3.74x3.19x–5.04x7755.5
2023 Q1–2025 Q496491.1%3.74x2.84x–4.97x956not 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
Texas24695.5%3.37x24542
Florida7898.7%2.64x7640
Arizona7290.3%3.60x7078
Indiana3485.3%4.24x3443
New York3190.3%4.20x3175

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
Texas157$105,884$743$2542.67x
Arizona39$23,571$743$1553.84x

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
Radiology49993.4%3.38x49546

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 73720?

In 2025 Q1–Q4, the provider or facility offer was selected in 91.7% of 516 determined dispute line items for CPT 73720. 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 73720?

In 2025 Q1–Q4, the median prevailing offer was 3.38x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.21x to 4.27x (n = 509 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 73720?

In 2025 Q1–Q4, the median was 46 business days (n = 516 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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