Federal IDR outcomes: Cardiology in New York
In 2025 Q1–Q4, the provider or facility offer prevailed in 75.8% of 1,076 determined Federal IDR dispute line items for cardiology in New York. The median prevailing offer was 5.40x the QPA (25th–75th percentile 2.04x–9.03x; n = 1,070). The median time to a decision was 53 business days (n = 1,076).
Determined line items
1,076
2025 Q1–Q4 · 6 split decisions excluded
Provider win rate
75.8%
n = 1,076 · 2025 Q1–Q4
Median payment vs QPA
5.40x
middle half 2.04x–9.03x · n = 1,070 · 2025 Q1–Q4
Median days to decision
53
business days, from dispute initiation · n = 1,076 · 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 | 1,076 | 75.8% | 5.40x | 2.04x–9.03x | 1,070 | 53 |
| 2024 Q1–Q4 | 498 | 79.9% | 6.28x | 2.94x–11.16x | 492 | 44 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 1,574 | 77.1% | 5.60x | 2.71x–9.98x | 1,562 | 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 |
|---|---|---|---|---|---|
| 99233 Subsequent hospital care with moderate levelof medical decision making, if using | 323 | 65.6% | 4.35x | 323 | 49 |
| 93623 Programming of heart rhythm stimulation after drug infusion | 93 | 86.0% | 6.16x | 92 | 72 |
| 93657 Destruction of tissue of upper heart chamber through tube to treat abnormal hear | 75 | 88.0% | 9.03x | 75 | 69 |
| 92960 External shock to heart to regulate heart beat | 62 | 80.6% | 10.00x | 60 | 48 |
| 93655 Insertion of catheters and destruction of tissue to treat abnormal heart rhythm | 61 | 80.3% | 8.80x | 61 | 65 |
| 93656 Comprehensive electrophysiologic evaluation with catheter destruction of abnorma | 60 | 81.7% | 12.42x | 60 | 68 |
| 93622 Insertion of catheters for recording and pacing of left lower heart chamber rhyt | 52 | 80.8% | 10.34x | 52 | 62.5 |
| 99223 Initial hospital care with moderate level of medical decision making, if using t | 37 | 78.4% | 4.40x | 37 | 33 |
| 99232 Subsequent hospital care with moderate levelof medical decision making, if using | 34 | 47.1% | 1.00x | 34 | 140 |
| 93620 Insertion of catheters for recording and pacing of right heart chambers rhythm a | 30 | 90.0% | 7.04x | 30 | 108.5 |
| 93653 Comprehensive electrophysiologic evaluation with catheter destruction of abnorma | 30 | 96.7% | 12.06x | 30 | 79.5 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in New York · Cardiology in all states
FAQ
What is the Federal IDR provider win rate for cardiology in New York?
In 2025 Q1–Q4, the provider or facility offer was selected in 75.8% of 1,076 determined dispute line items for cardiology in New York. 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 cardiology in New York?
In 2025 Q1–Q4, the median prevailing offer was 5.40x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 2.04x to 9.03x (n = 1,070 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 cardiology in New York?
In 2025 Q1–Q4, the median was 53 business days (n = 1,076 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).