Federal IDR outcomes: General and other surgery in Florida
In 2025 Q1–Q4, the provider or facility offer prevailed in 85.2% of 1,306 determined Federal IDR dispute line items for general and other surgery in Florida. The median prevailing offer was 11.34x the QPA (25th–75th percentile 1.25x–22.98x; n = 1,202). The median time to a decision was 29 business days (n = 1,306).
Determined line items
1,306
2025 Q1–Q4 · 0 split decisions excluded
Provider win rate
85.2%
n = 1,306 · 2025 Q1–Q4
Median payment vs QPA
11.34x
middle half 1.25x–22.98x · n = 1,202 · 2025 Q1–Q4
Median days to decision
29
business days, from dispute initiation · n = 1,306 · 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 | 1,306 | 85.2% | 11.34x | 1.25x–22.98x | 1,202 | 29 |
| 2024 Q1–Q4 | 853 | 89.1% | 13.68x | 9.70x–24.23x | 755 | 69 |
| 2023 Q1–Q4 | 306 | 88.2% | 10.14x | 5.93x–12.77x | 272 | 60.5 |
| 2023 Q1–2025 Q4 | 2,465 | 86.9% | 12.08x | 4.63x–21.56x | 2,229 | 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 |
|---|---|---|---|---|---|
| 47563 Removal of gallbladder with X-ray study of bile ducts using an endoscope | 259 | 85.7% | 19.51x | 246 | 29 |
| 44970 Removal of appendix using an endoscope | 176 | 77.8% | 15.24x | 171 | 25 |
| 99232 Subsequent hospital care with moderate levelof medical decision making, if using | 61 | 100.0% | 4.13x | 55 | 64 |
| 99291 Critical care, first 30-74 minutes | 37 | 100.0% | 3.42x | 37 | 46 |
| 99233 Subsequent hospital care with moderate levelof medical decision making, if using | 31 | 58.1% | – | 9 | 54 |
| 47562 Removal of gallbladder using an endoscope | 30 | 90.0% | – | 26 | 44.5 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in Florida · General and other surgery in all states
FAQ
What is the Federal IDR provider win rate for general and other surgery in Florida?
In 2025 Q1–Q4, the provider or facility offer was selected in 85.2% of 1,306 determined dispute line items for general and other surgery in Florida. 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 general and other surgery in Florida?
In 2025 Q1–Q4, the median prevailing offer was 11.34x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 1.25x to 22.98x (n = 1,202 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 general and other surgery in Florida?
In 2025 Q1–Q4, the median was 29 business days (n = 1,306 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).