Federal IDR outcomes: Vascular surgery in California
In 2025 Q1–Q4, the provider or facility offer prevailed in 87.9% of 1,929 determined Federal IDR dispute line items for vascular surgery in California. The median prevailing offer was 64.95x the QPA (25th–75th percentile 26.32x–114.26x; n = 1,924). The median time to a decision was 25 business days (n = 1,929).
Determined line items
1,929
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
87.9%
n = 1,929 · 2025 Q1–Q4
Median days to decision
25
business days, from dispute initiation · n = 1,929 · 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 | 1,929 | 87.9% | 64.95x † | 26.32x–114.26x | 1,924 | 25 |
| 2024 Q1–Q4 | 136 | 89.0% | 5.04x | 0.95x–41.45x | 135 | 75.5 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 2,082 | 88.0% | 61.46x † | 20.34x–111.32x | 2,076 | 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 |
|---|---|---|---|---|---|
| 99232 Subsequent hospital care with moderate levelof medical decision making, if using | 266 | 92.5% | 58.27x † | 266 | 32 |
| 99231 Subsequent hospital care with straightforward or low level of medical decision m | 225 | 92.4% | 99.05x † | 225 | 29 |
| 76937 Ultrasonic guidance for blood vessel access | 101 | 84.2% | 283.59x † | 101 | 25 |
| 22558 Fusion of lower spine bone through abdomen with partial removal of disc | 94 | 81.9% | 60.06x † | 92 | 22 |
| 36475 Destruction of first incompetent vein of arm or leg using radiofrequency and ima | 84 | 76.2% | 65.06x † | 84 | 22.5 |
| 99291 Critical care, first 30-74 minutes | 81 | 92.6% | 31.19x † | 81 | 27 |
| 22857 Insertion of artificial disc between bones of lower spine, single space | 58 | 89.7% | 71.57x † | 58 | 24.5 |
| 99152 Use of a drug to induce depression of consciousness by physician performing a pr | 53 | 90.6% | 303.36x † | 53 | 27 |
| 93970 Ultrasound study of arm or leg veins with compression and maneuvers | 46 | 82.6% | 254.54x † | 46 | 23 |
| 93971 Ultrasound study of one arm or leg veins with compression and maneuvers | 37 | 75.7% | 98.85x † | 37 | 20 |
| 99153 Use of a drug to induce depression of consciousness by physician performing a pr | 36 | 97.2% | 131.51x † | 36 | 24.5 |
| 36465 Injection of chemical agent into single incompetent vein of leg using ultrasound | 32 | 78.1% | 156.56x † | 32 | 23.5 |
| 99233 Subsequent hospital care with moderate levelof medical decision making, if using | 32 | 93.8% | 43.76x † | 32 | 23.5 |
| 22585 Fusion of spine bones through front of body with partial removal of disc, each a | 31 | 90.3% | 64.95x † | 31 | 21 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in California · Vascular surgery in all states
FAQ
What is the Federal IDR provider win rate for vascular surgery in California?
In 2025 Q1–Q4, the provider or facility offer was selected in 87.9% of 1,929 determined dispute line items for vascular surgery 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 vascular surgery in California?
In 2025 Q1–Q4, the median prevailing offer was 64.95x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 26.32x to 114.26x (n = 1,924 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 vascular surgery in California?
In 2025 Q1–Q4, the median was 25 business days (n = 1,929 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).