IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Emergency medicine and emergency departments in Arizona

In 2025 Q1–Q4, the provider or facility offer prevailed in 82.7% of 177,255 determined Federal IDR dispute line items for emergency medicine and emergency departments in Arizona. The median prevailing offer was 3.42x the QPA (25th–75th percentile 2.01x–7.31x; n = 132,797). The median time to a decision was 41 business days (n = 177,255).

Determined line items

177,255

2025 Q1–Q4 · 182 split decisions excluded

Provider win rate

82.7%

n = 177,255 · 2025 Q1–Q4

Median payment vs QPA

3.42x

middle half 2.01x–7.31x · n = 132,797 · 2025 Q1–Q4

Median days to decision

41

business days, from dispute initiation · n = 177,255 · 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

PeriodLine itemsWin %Median ×QPA25th–75thRatio nMedian days
2025 Q1–Q4177,25582.7%3.42x2.01x–7.31x132,79741
2024 Q1–Q461,43180.1%3.37x1.67x–5.50x44,55983
2023 Q1–Q45,96385.0%1.92x1.64x–2.26x5,32672
2023 Q1–2025 Q4244,64982.1%3.30x1.92x–6.59x182,682not 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.

Most disputed CPT codes

CPT codeLine itemsWin %Median ×QPARatio nMedian days
99284 Emergency department visit with moderate level of medical decision making64,43281.0%2.74x48,23644
99285 Emergency department visit with high level of medical decision making46,42582.7%3.00x30,59747
99283 Emergency department visit with low level of medical decision making12,73186.3%4.44x10,44233
99291 Critical care, first 30-74 minutes5,78087.7%3.63x3,68339
93010 Routine electrocardiogram (ECG) using at least 12 leads with interpretation and 5,13087.9%4.51x2,40144
80053 Blood test, comprehensive group of blood chemicals3,18582.5%13.32x2,98033
85025 Complete blood cell count (red cells, white blood cell, platelets), automated te2,66583.3%9.42x2,45535
81003 Automated urinalysis test1,80781.6%15.20x1,75131
83690 Lipase (fat enzyme) level1,40783.5%9.74x1,33832
93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing1,25984.3%7.49x1,16534
96374 Injection of drug or substance into vein1,17481.0%2.61x1,06634
74177 CT scan of abdomen and pelvis with contrast1,03779.7%12.17x97034
84484 Troponin (protein) analysis, quantitative1,00084.3%8.34x93032.5
87637 Detection test by multiplex amplified probe technique for severe acute respirato84480.5%3.08x84431
96361 Infusion into a vein for hydration, each additional hour73782.1%5.23x69334
99282 Emergency department visit with straightforward medical decision making71785.8%4.29x69626
71045 X-ray of chest, 1 view70483.9%6.15x57737
71046 X-ray of chest, 2 views68881.4%7.28x66333
96375 Injection of additional new drug or substance into vein68781.8%3.72x60139
85027 Complete blood cell count (red cells, white blood cell, platelets), automated te65479.2%8.80x63529.5

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

Related: all specialties in Arizona · Emergency medicine and emergency departments in all states

FAQ

What is the Federal IDR provider win rate for emergency medicine and emergency departments in Arizona?

In 2025 Q1–Q4, the provider or facility offer was selected in 82.7% of 177,255 determined dispute line items for emergency medicine and emergency departments in Arizona. 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 emergency medicine and emergency departments in Arizona?

In 2025 Q1–Q4, the median prevailing offer was 3.42x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.01x to 7.31x (n = 132,797 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 emergency medicine and emergency departments in Arizona?

In 2025 Q1–Q4, the median was 41 business days (n = 177,255 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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