IDR Data
CMS PUF data · 2023 Q1–2025 Q4

CPT 77062: Federal IDR outcomes

3D breast mammography of both breasts

In 2025 Q1–Q4, the provider or facility offer prevailed in 93.9% of 1,519 determined Federal IDR dispute line items for CPT 77062. The median prevailing offer was 2.09x the QPA (25th–75th percentile 2.04x–2.50x; n = 1,514). The median time to a decision was 75 business days (n = 1,519).

Determined line items

1,519

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

93.9%

n = 1,519 · 2025 Q1–Q4

Median payment vs QPA

2.09x

middle half 2.04x–2.50x · n = 1,514 · 2025 Q1–Q4

Median days to decision

75

business days, from dispute initiation · n = 1,519 · 2025 Q1–Q4

Dollar amounts

Total awarded

$153,142

sum of prevailing offers · n = 1,251 · 2025 Q1–Q4

Total QPA

$71,886

sum of QPAs, same line items · n = 1,251 · 2025 Q1–Q4

Awarded above QPA

$81,257

total awarded minus total QPA · n = 1,251 · 2025 Q1–Q4

Median award per line item

$100

mean $122 · n = 1,251 · 2025 Q1–Q4

Median QPA

$48

per line item · n = 1,251 · 2025 Q1–Q4

Award vs QPA, dollar-weighted

2.13x

total awarded ÷ total QPA · n = 1,251 · 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–Q41,251$153,142$71,886$81,257$100$482.13x
2024 Q3–Q41,033$120,747$56,927$63,820$100$482.12x
2024 Q3–2025 Q42,284$273,889$128,812$145,076$100$482.13x
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–Q41,51993.9%2.09x2.04x–2.50x1,51475
2024 Q1–Q41,21895.2%2.09x1.98x–2.44x1,21888
2023 Q1–Q416768.3%1.59x1.05x–1.85x16769
2023 Q1–2025 Q42,90493.0%2.09x1.98x–2.44x2,899not 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
Florida70999.4%2.09x70959
New York33188.5%2.15x331106
Indiana15492.9%2.75x152175.5
Nevada99100.0%2.04x9960
Illinois6795.5%3.28x6750
Ohio3491.2%1.63x3466.5
Texas3287.5%3.13x3133

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
Florida436$43,653$100$482.16x
New York287$44,358$172$802.07x
New Jersey276$42,917$172$802.06x
Pennsylvania276$42,917$172$802.06x
Indiana111$20,146$186$692.65x
Illinois52$9,339$186$602.48x
Wisconsin52$9,339$186$602.48x
Nevada48$3,949$82$401.95x

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
Radiology1,50994.2%2.09x1,50777

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 77062?

In 2025 Q1–Q4, the provider or facility offer was selected in 93.9% of 1,519 determined dispute line items for CPT 77062. 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 77062?

In 2025 Q1–Q4, the median prevailing offer was 2.09x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.04x to 2.50x (n = 1,514 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 77062?

In 2025 Q1–Q4, the median was 75 business days (n = 1,519 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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