Federal IDR outcomes: Obstetrics and gynecology in New Jersey
In 2025 Q1–Q4, the provider or facility offer prevailed in 87.8% of 3,210 determined Federal IDR dispute line items for obstetrics and gynecology in New Jersey. The median prevailing offer was 22.44x the QPA (25th–75th percentile 8.43x–64.57x; n = 3,061). The median time to a decision was 29 business days (n = 3,210).
Determined line items
3,210
2025 Q1–Q4 · 4 split decisions excluded
Provider win rate
87.8%
n = 3,210 · 2025 Q1–Q4
Median days to decision
29
business days, from dispute initiation · n = 3,210 · 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 | 3,210 | 87.8% | 22.44x † | 8.43x–64.57x | 3,061 | 29 |
| 2024 Q1–Q4 | 1,043 | 86.9% | 12.68x | 6.12x–23.96x | 1,003 | 40 |
| 2023 Q1–Q4 | 142 | 88.7% | 7.16x | 4.56x–14.90x | 142 | 20 |
| 2023 Q1–2025 Q4 | 4,395 | 87.6% | 18.90x | 6.81x–51.61x | 4,206 | 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 | 381 | 92.7% | 38.56x † | 369 | 30 |
| 59400 Vaginal delivery with care before and after delivery | 373 | 86.6% | 13.97x | 362 | 33 |
| 64999 Other procedure on nervous system | 178 | 91.0% | 120.59x † | 159 | 31.5 |
| 58558 Biopsy of lining of uterus and/or removal of polyp using an endoscope | 169 | 94.1% | 27.47x † | 165 | 30 |
| 59510 Cesarean delivery with care before and after delivery | 160 | 83.8% | 12.90x | 156 | 30.5 |
| 50949 Other procedure on ureter using an endoscope | 118 | 87.3% | 23.02x † | 106 | 30 |
| 45499 Other procedure on rectum using an endoscope | 107 | 90.7% | 19.96x | 99 | 29 |
| 58542 Partial removal of uterus, tubes, and/or ovaries with retention of cervix using | 73 | 89.0% | 27.17x † | 70 | 30 |
| 54150 Removal of foreskin using clamp or device | 68 | 82.4% | 21.57x † | 66 | 34.5 |
| 58661 Removal of ovaries and/or tubes using an endoscope | 65 | 86.2% | 56.52x † | 63 | 30 |
| 59610 Vaginal delivery and care before and after delivery after previous cesarean deli | 61 | 83.6% | 15.68x | 61 | 33 |
| 44180 Release of small bowel scar tissue using an endoscope | 60 | 71.7% | 11.94x | 60 | 25.5 |
| 58999 Other procedure on female genital system (nonobstetrical) | 56 | 96.4% | 55.78x † | 52 | 27.5 |
| 44970 Removal of appendix using an endoscope | 55 | 92.7% | 151.10x † | 55 | 27 |
| 58545 Removal of growth of uterus using an endoscope, 250.0 g or less | 51 | 94.1% | 24.72x † | 50 | 30 |
| 59514 Cesarean delivery | 39 | 84.6% | 47.07x † | 37 | 31 |
| 49329 Other procedure on abdomen using an endoscope | 38 | 94.7% | 36.84x † | 36 | 24 |
| 58578 Other procedure on uterus using an endoscope | 37 | 91.9% | 30.49x † | 35 | 40 |
| 99284 Emergency department visit with moderate level of medical decision making | 37 | 78.4% | 72.16x † | 30 | 30 |
| 99222 Initial hospital care with straightforward or low-level medical decision making, | 36 | 77.8% | 27.26x † | 35 | 23 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in New Jersey · Obstetrics and gynecology in all states
FAQ
What is the Federal IDR provider win rate for obstetrics and gynecology in New Jersey?
In 2025 Q1–Q4, the provider or facility offer was selected in 87.8% of 3,210 determined dispute line items for obstetrics and gynecology in New Jersey. 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 New Jersey?
In 2025 Q1–Q4, the median prevailing offer was 22.44x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 8.43x to 64.57x (n = 3,061 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 New Jersey?
In 2025 Q1–Q4, the median was 29 business days (n = 3,210 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).