Federal IDR outcomes: Radiology
In 2025 Q1–Q4, the provider or facility offer prevailed in 94.1% of 895,085 determined Federal IDR dispute line items for radiology. The median prevailing offer was 4.74x the QPA (25th–75th percentile 2.85x–7.37x; n = 892,752). The median time to a decision was 50 business days (n = 895,085).
Specialty group built from the CMS free-text specialty field; see the grouping rules.
Determined line items
895,085
2025 Q1–Q4 · 831 split decisions excluded
Provider win rate
94.1%
n = 895,085 · 2025 Q1–Q4
Median payment vs QPA
4.74x
middle half 2.85x–7.37x · n = 892,752 · 2025 Q1–Q4
Median days to decision
50
business days, from dispute initiation · n = 895,085 · 2025 Q1–Q4
Dollar amounts are not shown for specialty groups: the CMS QPA and Offers file, the only source of dollar figures, has no specialty field. See methodology.
By period
| Period | Line items | Win % | Median ×QPA | 25th–75th | Ratio n | Median days |
|---|---|---|---|---|---|---|
| 2025 Q1–Q4 | 895,085 | 94.1% | 4.74x | 2.85x–7.37x | 892,752 | 50 |
| 2024 Q1–Q4 | 578,389 | 93.3% | 5.64x | 3.67x–8.07x | 577,820 | 83 |
| 2023 Q1–Q4 | 96,430 | 85.7% | 4.23x | 2.63x–7.66x | 93,951 | 69 |
| 2023 Q1–2025 Q4 | 1,569,904 | 93.3% | 4.98x | 3.04x–7.80x | 1,564,523 | not 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 items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| Texas | 515,706 | 95.1% | 5.02x | 514,740 | 52 |
| Arizona | 119,766 | 92.6% | 5.54x | 119,603 | 59 |
| Florida | 92,274 | 98.4% | 3.26x | 91,340 | 42 |
| New York | 61,363 | 91.1% | 5.27x | 61,301 | 78 |
| Indiana | 53,378 | 90.8% | 5.34x | 53,272 | 40 |
| Nevada | 11,662 | 98.0% | 2.64x | 11,583 | 51 |
| Illinois | 9,908 | 94.7% | 5.40x | 9,908 | 42 |
| Georgia | 7,376 | 78.9% | 2.81x | 7,371 | 50 |
| South Carolina | 7,321 | 69.5% | 19.64x | 7,317 | 35 |
| Oregon | 3,159 | 58.1% | 2.10x | 3,159 | 41 |
| Michigan | 2,910 | 98.2% | 4.32x | 2,910 | 22 |
| Ohio | 2,790 | 90.7% | 2.89x | 2,789 | 44 |
| Tennessee | 2,599 | 93.6% | 2.40x | 2,597 | 32 |
| Louisiana | 2,258 | 92.1% | 1.64x | 2,255 | 43 |
| Kansas | 617 | 76.5% | 1.62x | 617 | 55 |
| Maryland | 588 | 100.0% | 2.06x | 588 | 42 |
| Missouri | 584 | 86.5% | 1.92x | 584 | 47 |
| Alabama | 351 | 86.9% | 2.30x | 350 | 19 |
| California | 137 | 78.1% | 120.30x † | 136 | 22 |
| New Jersey | 135 | 83.7% | 6.47x | 130 | 68 |
| North Carolina | 47 | 8.5% | 1.00x | 47 | 50 |
| Arkansas | 44 | 95.5% | 2.20x | 44 | 24 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Most disputed CPT codes
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 71045 X-ray of chest, 1 view | 91,120 | 93.2% | 6.95x | 91,012 | 72 |
| 77067 Screening mammography | 79,315 | 95.2% | 2.88x | 79,222 | 58 |
| 77063 Screening 3D breast mammography | 73,946 | 95.9% | 2.51x | 73,852 | 61 |
| 74177 CT scan of abdomen and pelvis with contrast | 64,614 | 94.0% | 6.40x | 64,385 | 45 |
| 70450 CT scan head or brain without contrast | 46,920 | 94.1% | 4.74x | 46,766 | 51 |
| 71046 X-ray of chest, 2 views | 38,896 | 93.9% | 7.35x | 38,848 | 56 |
| 74176 CT scan of abdomen and pelvis without contrast | 26,645 | 94.0% | 6.26x | 26,537 | 47 |
| 71275 CT scan of blood vessels of chest with contrast | 22,133 | 93.7% | 5.79x | 22,019 | 48 |
| 76705 Limited ultrasound scan of abdomen | 18,028 | 94.7% | 6.05x | 17,996 | 42 |
| 74018 X-ray of abdomen, 1 view | 14,475 | 94.5% | 6.50x | 14,445 | 57 |
| 72125 CT scan of upper spine without contrast | 12,514 | 93.3% | 4.63x | 12,470 | 44 |
| 76641 Complete ultrasound scan of 1 breast | 12,248 | 93.0% | 5.81x | 12,230 | 53 |
| 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | 11,586 | 94.8% | 5.01x | 11,556 | 49 |
| 70498 CT scan of blood vessels of neck with contrast | 10,772 | 93.8% | 5.45x | 10,717 | 51 |
| 70496 CT scan of blood vessels of head with contrast | 10,507 | 93.7% | 4.64x | 10,449 | 52 |
| 76642 Limited ultrasound scan of 1 breast | 10,217 | 92.6% | 5.41x | 10,195 | 45 |
| 71260 CT scan of chest with contrast | 9,750 | 93.5% | 4.59x | 9,714 | 49 |
| 70553 MRI scan of brain before and after contrast | 9,515 | 93.9% | 4.18x | 9,473 | 46 |
| 71250 CT scan of chest without contrast | 8,968 | 93.9% | 4.61x | 8,942 | 46 |
| 76856 Complete ultrasound scan of pelvis | 8,693 | 94.1% | 5.54x | 8,657 | 51 |
| 70551 MRI scan of brain without contrast | 8,490 | 94.0% | 3.93x | 8,457 | 51 |
| 77066 Diagnostic mammography of both breasts | 8,333 | 95.7% | 3.13x | 8,322 | 59 |
| 77065 Diagnostic mammography of 1 breast | 8,139 | 95.1% | 3.16x | 8,134 | 65 |
| 93971 Ultrasound study of one arm or leg veins with compression and maneuvers | 7,754 | 94.7% | 8.05x | 7,749 | 35 |
| 76815 Limited ultrasound of pregnant uterus | 7,734 | 95.2% | 5.14x | 7,678 | 47 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
FAQ
What is the Federal IDR provider win rate for radiology?
In 2025 Q1–Q4, the provider or facility offer was selected in 94.1% of 895,085 determined dispute line items for radiology. 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 radiology?
In 2025 Q1–Q4, the median prevailing offer was 4.74x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.85x to 7.37x (n = 892,752 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 radiology?
In 2025 Q1–Q4, the median was 50 business days (n = 895,085 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).