Federal IDR benchmarks explorer
Based on 5,722,691 determined line items · 2025 Q1–Q4 · 5,446 split decisions excluded
Provider win rate
85.6%
n = 5,722,691 · 2025 Q1–Q4
Median payment vs QPA
3.99x
middle half 2.22x–8.13x · n = 4,669,527 · 2025 Q1–Q4
Median days to decision
35
business days, from dispute initiation · n = 5,722,691 · 2025 Q1–Q4
Dollar amounts
Total awarded
$12.00B
sum of prevailing offers · n = 4,366,449 · 2025 Q1–Q4
Total QPA
$1.74B
sum of QPAs, same line items · n = 4,366,449 · 2025 Q1–Q4
Awarded above QPA
$10.25B
total awarded minus total QPA · n = 4,366,449 · 2025 Q1–Q4
Median award per line item
$618
mean $2,747 · n = 4,366,449 · 2025 Q1–Q4
Median QPA
$158
per line item · n = 4,366,449 · 2025 Q1–Q4
Award vs QPA, dollar-weighted
6.88x
total awarded ÷ total QPA · n = 4,366,449 · 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 state
| State (region) | Line items with $ | Total awarded | Median award | Median QPA | Award ×QPA |
|---|---|---|---|---|---|
| Texas | 1,531,702 | $4.52B | $541 | $118 | 7.96x |
| Arizona | 309,051 | $706.5M | $569 | $142 | 7.69x |
| New York | 217,126 | $2.22B | $1,001 | $199 | 12.94x |
| Pennsylvania | 216,587 | $2.24B | $1,225 | $190 | 13.04x |
| Florida | 214,867 | $204.2M | $544 | $221 | 2.71x |
| New Jersey | 211,765 | $2.25B | $1,400 | $192 | 12.85x |
| Arkansas | 199,743 | $261.3M | $568 | $140 | 3.55x |
| Tennessee | 192,824 | $214.9M | $606 | $174 | 2.97x |
| Indiana | 149,010 | $175.8M | $566 | $170 | 3.56x |
| Georgia | 121,385 | $161.6M | $658 | $257 | 3.49x |
| California | 119,246 | $456.0M | $569 | $183 | 5.39x |
| Mississippi | 115,399 | $110.1M | $408 | $135 | 2.77x |
| Oklahoma | 89,245 | $141.5M | $616 | $160 | 5.33x |
| Illinois | 88,520 | $87.7M | $634 | $166 | 3.85x |
| Ohio | 72,060 | $133.1M | $633 | $222 | 6.65x |
| Louisiana | 69,504 | $77.2M | $685 | $171 | 3.80x |
| Virginia | 67,363 | $81.2M | $791 | $207 | 4.54x |
| Wisconsin | 65,508 | $82.9M | $604 | $175 | 3.04x |
| Missouri | 60,801 | $62.9M | $648 | $163 | 2.59x |
| Nevada | 53,262 | $49.7M | $573 | $186 | 3.85x |
| North Carolina | 47,489 | $39.8M | $632 | $255 | 2.71x |
| South Carolina | 46,406 | $67.6M | $614 | $206 | 5.25x |
| Kentucky | 46,078 | $94.0M | $645 | $202 | 7.08x |
| New Mexico | 40,793 | $64.9M | $799 | $166 | 4.93x |
| Maryland | 39,487 | $74.5M | $836 | $213 | 3.81x |
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 provider group
| Provider group | Disputes | Win % | Award ×QPA | Total awarded (≈) |
|---|---|---|---|---|
| Singleton Associates, P.A. | 117,512 | 95.0% | 5.74x | ≈ $165.8M |
| OrthoMed Staffing, LLC | 49,452 | 84.3% | 9.23x | ≈ $212.7M |
| Houston Radiology Associated | 49,069 | 97.0% | 4.41x | ≈ $27.5M |
| Sonoran Radiology, LTD | 40,323 | 92.0% | 5.49x | ≈ $45.1M |
| U.S. Anesthesia Partners of Texas, P.A. | 28,607 | 84.6% | 3.14x | ≈ $67.0M |
| PRECISION EMERGENCY PHYSICIANS | 26,053 | 92.0% | 6.56x | ≈ $70.2M |
| SOUTHEASTERN EMERGENCY PHYSICIANS LLC | 25,354 | 92.9% | 3.27x | ≈ $32.6M |
| Imaging Associates of Indiana, PC | 25,118 | 90.4% | 5.33x | ≈ $22.2M |
| Remote Neuromonitoring Physicians PC | 24,399 | 88.7% | 13.41x | ≈ $71.0M |
| FREMONT EMERGENCY SERVICES SCHERR LTD | 21,937 | 93.8% | 2.65x | ≈ $22.0M |
| Physician Oversight LLC | 20,777 | 84.1% | 13.20x | ≈ $56.7M |
| Mori, Bean, and Brooks, Inc. | 20,306 | 98.1% | 3.25x | ≈ $21.3M |
| NPPA SERVICES | 17,397 | 91.5% | 79.55x | ≈ $151.0M |
| EMERGENCY PROFESSIONALS OF INDIANA PC | 14,490 | 92.3% | 2.64x | ≈ $13.5M |
| SUMMIT ANESTHESIA PARTNERS | 13,432 | 88.1% | 18.89x | ≈ $104.6M |
| Empire State Radiology, P.C. | 12,400 | 90.5% | 5.26x | ≈ $19.4M |
| EMERGENCY COVERAGE LLC | 12,147 | 91.7% | 2.18x | ≈ $11.9M |
| SPRINGFIELD SURGERY CENTER | 11,719 | 86.0% | 37.85x | — |
| ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC | 11,650 | 94.6% | 2.59x | ≈ $14.3M |
| U.S. Anesthesia Partners of Florida, Inc. | 11,638 | 86.3% | 2.28x | ≈ $26.5M |
| PARAGON CONTRACTING SERVICES LLC | 10,879 | 91.5% | 2.64x | ≈ $16.1M |
| EVOKES, LLC | 10,855 | 82.1% | 82.56x | ≈ $85.7M |
| TEXAS MEDICINE RESOURCES LLP | 10,550 | 96.7% | 2.37x | ≈ $12.2M |
| EMERGENCY PHYSICIANS SOUTHWEST PC | 9,110 | 94.9% | 2.19x | ≈ $11.5M |
| INPHYNET SOUTH BROWARD LLC | 8,932 | 91.6% | 1.73x | ≈ $10.3M |
2025 Q1–Q4 · top 25 groups by disputes · groups with n ≥ 30 determined line items.
Provider group = the CMS “Provider/Facility Group Name”, with spelling variants merged (rules). Disputes = distinct dispute numbers among the group’s determined line items. Win % = line items where the provider or facility offer prevailed ÷ provider plus plan determinations (split decisions excluded, default decisions included). ×QPA = median “Prevailing Party Offer as % of QPA”. Groups need at least 30 determined line items.
≈ Total awarded: sum of prevailing offers, 2025 Q1–Q4 only. CMS does not publish dollars per provider; amounts are estimates from the CMS QPA and Offers file. “—” = too few of the group’s line items could be matched to that file to show an estimate. How the estimates work
By state
| State | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| Texas | 2,535,325 | 85.8% | 4.80x | 2,031,391 | 32 |
| Arizona | 439,946 | 83.3% | 4.80x | 330,224 | 38 |
| Florida | 383,099 | 87.6% | 2.59x | 331,870 | 41 |
| Tennessee | 231,229 | 83.8% | 2.84x | 193,057 | 43 |
| California | 209,808 | 88.5% | 2.63x | 146,356 | 36 |
| New York | 172,628 | 86.5% | 5.38x | 157,282 | 44 |
| Georgia | 169,397 | 85.8% | 2.98x | 127,875 | 41 |
| New Jersey | 158,058 | 86.0% | 13.48x | 115,815 | 37 |
| Indiana | 135,766 | 87.3% | 3.59x | 133,834 | 34 |
| Oklahoma | 121,005 | 92.4% | 5.23x | 108,767 | 32 |
| Arkansas | 96,183 | 87.7% | 4.85x | 91,910 | 35 |
| Nevada | 82,972 | 91.6% | 2.73x | 67,135 | 40 |
| Louisiana | 82,853 | 76.1% | 3.81x | 81,326 | 32 |
| Ohio | 82,211 | 87.0% | 2.71x | 78,632 | 37 |
| Virginia | 69,753 | 84.2% | 3.30x | 66,339 | 44 |
| Missouri | 69,647 | 87.6% | 4.16x | 60,217 | 41 |
| Mississippi | 65,536 | 85.7% | 3.44x | 57,694 | 39 |
| New Mexico | 61,351 | 93.8% | 5.21x | 59,498 | 32 |
| Alabama | 54,152 | 86.3% | 4.82x | 50,088 | 41 |
| North Carolina | 49,781 | 82.6% | 2.64x | 44,548 | 35 |
| South Carolina | 44,254 | 83.2% | 3.12x | 43,660 | 40 |
| Michigan | 43,925 | 93.0% | 3.91x | 25,208 | 33 |
| Pennsylvania | 42,822 | 90.4% | 4.45x | 24,584 | 34 |
| Illinois | 37,387 | 87.7% | 4.37x | 35,371 | 36 |
| Kansas | 35,612 | 91.7% | 3.50x | 31,835 | 30 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
By CPT code
| Code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 99284 Emergency department visit with moderate level of medical decision mak | 1,006,708 | 85.4% | 3.31x | 924,921 | 35 |
| 99285 Emergency department visit with high level of medical decision making | 586,138 | 84.9% | 2.87x | 521,358 | 38 |
| 99283 Emergency department visit with low level of medical decision making | 269,346 | 84.0% | 3.84x | 247,955 | 29 |
| 71045 X-ray of chest, 1 view | 112,897 | 91.2% | 5.86x | 107,305 | 60 |
| 85025 Complete blood cell count (red cells, white blood cell, platelets), au | 95,604 | 83.9% | 4.36x | 59,492 | 32 |
| 74177 CT scan of abdomen and pelvis with contrast | 95,207 | 89.5% | 6.26x | 87,290 | 40 |
| 77067 Screening mammography | 79,879 | 94.6% | 2.85x | 79,775 | 58 |
| 99291 Critical care, first 30-74 minutes | 76,635 | 87.1% | 3.36x | 66,969 | 34 |
| 80053 Blood test, comprehensive group of blood chemicals | 75,429 | 84.3% | 5.14x | 49,677 | 32 |
| 77063 Screening 3D breast mammography | 74,572 | 95.2% | 2.51x | 74,474 | 61.5 |
| 71046 X-ray of chest, 2 views | 69,477 | 88.5% | 7.15x | 61,685 | 41 |
| 70450 CT scan head or brain without contrast | 67,709 | 90.3% | 4.74x | 61,536 | 43 |
| 95938 Placement of skin electrodes and measurement of stimulated sites on ar | 58,730 | 86.9% | 37.11x † | 49,838 | 33 |
| 00812 Anesthesia for exam of colon using an endoscope | 50,910 | 77.9% | 4.16x | 46,056 | 35 |
| 96375 Injection of additional new drug or substance into vein | 49,566 | 85.1% | 4.88x | 30,786 | 31 |
| 81003 Automated urinalysis test | 48,639 | 82.1% | 6.36x | 30,718 | 29 |
| 74176 CT scan of abdomen and pelvis without contrast | 44,846 | 88.5% | 6.17x | 39,178 | 38 |
| 96374 Injection of drug or substance into vein | 44,710 | 84.6% | 3.44x | 27,887 | 31 |
| 96361 Infusion into a vein for hydration, each additional hour | 43,523 | 84.5% | 4.37x | 27,055 | 31 |
| 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | 40,945 | 84.8% | 3.37x | 25,871 | 33 |
| 95941 Continuous remote monitoring of nervous system during operation, each | 39,437 | 88.1% | 13.06x | 33,128 | 32 |
| 84484 Troponin (protein) analysis, quantitative | 36,481 | 83.9% | 3.84x | 22,364 | 32 |
| 93010 Routine electrocardiogram (ECG) using at least 12 leads with interpret | 36,472 | 88.2% | 6.26x | 26,721 | 30 |
| 96372 Injection of drug or substance under skin or into muscle | 35,183 | 82.9% | 4.06x | 19,565 | 28 |
| 95939 Placement of skin electrodes and measurement of central motor stimulat | 32,685 | 86.4% | 16.94x | 27,955 | 32 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
By payer
| Payer | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| UNITED HEALTHCARE (uhc.com) | 1,241,270 | 83.2% | 3.66x | 978,628 | 44 |
| BCBSTX (bcbstx.com) | 1,198,478 | 87.8% | 6.06x | 950,459 | 27 |
| AETNA (aetna.com) | 847,450 | 90.6% | 3.96x | 681,123 | 33 |
| CIGNA (multiplan.com) | 528,646 | 79.4% | 4.23x | 457,294 | 45 |
| CIGNA (cigna.com) | 326,997 | 81.6% | 2.71x | 288,996 | 40 |
| ANTHEM BLUE CROSS BLUE SHIELD (anthem.com) | 320,340 | 87.6% | 3.61x | 272,129 | 38 |
| UMR (clearhs.com) | 279,301 | 85.0% | 3.40x | 247,246 | 33 |
| BLUE CROSS AND BLUE SHIELD OF ARIZONA (azblue.com) | 146,972 | 78.0% | 5.63x | 90,460 | 31 |
| AMBETTER (centene.com) | 129,459 | 90.4% | 2.89x | 98,065 | 31 |
| UMR (clearhealthcloud.com) | 127,346 | 85.8% | 2.76x | 116,894 | 36 |
| FLORIDA BLUE (bcbsfl.com) | 74,463 | 96.4% | 3.16x | 72,001 | 28 |
| BCBS OF TX (bcbsil.com) | 74,307 | 88.8% | 5.00x | 71,737 | 44 |
| BLUECROSS BLUESHIELD OF NEW MEXICO (bcbsnm.com) | 40,744 | 97.6% | 5.24x | 39,013 | 32 |
| CIGNA (zelis.com) | 34,062 | 94.5% | 2.94x | 27,730 | 47 |
| BCBSLA (lablue.com) | 22,120 | 49.1% | 3.62x | 21,984 | 36 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Win rate = line items where the provider or facility offer prevailed, divided by provider plus plan determinations; split decisions are excluded and default decisions included. Payment vs QPA = the CMS field “Prevailing Party Offer as % of QPA” (1.00x equals the QPA). State = place of service. Payer = health plan email domain. Figures need at least 30 line items. Source: CMS Federal IDR public use files, 2023 Q1–2025 Q4. Methodology