Federal IDR outcomes: Obstetrics and gynecology in California
In 2025 Q1–Q4, the provider or facility offer prevailed in 92.3% of 2,435 determined Federal IDR dispute line items for obstetrics and gynecology in California. The median prevailing offer was 45.34x the QPA (25th–75th percentile 17.57x–200.60x; n = 2,388). The median time to a decision was 27 business days (n = 2,435).
Determined line items
2,435
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
92.3%
n = 2,435 · 2025 Q1–Q4
Median days to decision
27
business days, from dispute initiation · n = 2,435 · 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 | 2,435 | 92.3% | 45.34x † | 17.57x–200.60x | 2,388 | 27 |
| 2024 Q1–Q4 | 510 | 93.1% | 39.36x † | 16.14x–176.11x | 510 | 41 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 2,946 | 92.4% | 44.26x † | 16.88x–194.33x | 2,899 | 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.
Most disputed CPT codes
| CPT code | Line items | Win % | Median ×QPA | Ratio n | Median days |
|---|---|---|---|---|---|
| 58662 Destruction or removal of ovary or growth of pelvis using an endoscope | 294 | 89.5% | 152.48x † | 293 | 28 |
| 45300 Diagnostic exam of rectum and lower large bowel using an endoscope | 192 | 95.8% | 218.06x † | 192 | 27 |
| 50949 Other procedure on ureter using an endoscope | 177 | 92.1% | 23.53x † | 167 | 25 |
| 45499 Other procedure on rectum using an endoscope | 176 | 88.6% | 19.07x | 167 | 25 |
| 52260 Dilation of bladder using an endoscope under general or spinal anesthesia | 156 | 95.5% | 65.85x † | 155 | 29 |
| 58578 Other procedure on uterus using an endoscope | 147 | 91.8% | 19.95x | 144 | 27 |
| 58999 Other procedure on female genital system (nonobstetrical) | 137 | 93.4% | 23.72x † | 132 | 26 |
| 44238 Other procedure on bowel using an endoscope | 131 | 90.8% | 22.07x † | 127 | 25 |
| 58558 Biopsy of lining of uterus and/or removal of polyp using an endoscope | 127 | 89.8% | 63.63x † | 127 | 28 |
| 51999 Other procedure on bladder using an endoscope | 98 | 95.9% | 17.59x | 95 | 27 |
| 58560 Release of scar tissue of uterus and release or removal and septum using an endo | 78 | 97.4% | 40.82x † | 78 | 27 |
| 44979 Other procedure on appendix using an endoscope | 75 | 93.3% | 24.10x † | 73 | 28 |
| 64999 Other procedure on nervous system | 70 | 95.7% | 152.14x † | 68 | 25 |
| 58545 Removal of growth of uterus using an endoscope, 250.0 g or less | 55 | 96.4% | 198.75x † | 55 | 25 |
| 44970 Removal of appendix using an endoscope | 49 | 98.0% | 44.26x † | 48 | 25 |
| 58661 Removal of ovaries and/or tubes using an endoscope | 38 | 86.8% | 124.90x † | 38 | 29 |
| 58571 Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250 | 33 | 84.8% | 31.90x † | 33 | 23 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in California · Obstetrics and gynecology in all states
FAQ
What is the Federal IDR provider win rate for obstetrics and gynecology in California?
In 2025 Q1–Q4, the provider or facility offer was selected in 92.3% of 2,435 determined dispute line items for obstetrics and gynecology in California. 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 obstetrics and gynecology in California?
In 2025 Q1–Q4, the median prevailing offer was 45.34x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 17.57x to 200.60x (n = 2,388 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 obstetrics and gynecology in California?
In 2025 Q1–Q4, the median was 27 business days (n = 2,435 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).