Federal IDR outcomes: Obstetrics and gynecology in New York
In 2025 Q1–Q4, the provider or facility offer prevailed in 90.4% of 4,688 determined Federal IDR dispute line items for obstetrics and gynecology in New York. The median prevailing offer was 30.65x the QPA (25th–75th percentile 10.87x–78.65x; n = 4,346). The median time to a decision was 30 business days (n = 4,688).
Determined line items
4,688
2025 Q1–Q4 · 8 split decisions excluded
Provider win rate
90.4%
n = 4,688 · 2025 Q1–Q4
Median days to decision
30
business days, from dispute initiation · n = 4,688 · 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 | 4,688 | 90.4% | 30.65x † | 10.87x–78.65x | 4,346 | 30 |
| 2024 Q1–Q4 | 1,314 | 90.2% | 21.48x † | 5.63x–52.42x | 1,164 | 43 |
| 2023 Q1–Q4 | 130 | 96.2% | 9.84x | 5.60x–21.06x | 130 | 31 |
| 2023 Q1–2025 Q4 | 6,132 | 90.4% | 27.35x † | 9.30x–73.57x | 5,640 | 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 | 587 | 89.3% | 45.28x † | 567 | 30 |
| 58558 Biopsy of lining of uterus and/or removal of polyp using an endoscope | 410 | 92.9% | 25.71x † | 409 | 32 |
| 76817 Vaginal ultrasound of pregnant uterus | 333 | 90.4% | 111.11x † | 333 | 32 |
| 59840 Induced abortion by dilation and scraping of uterine | 274 | 88.7% | 51.42x † | 274 | 34 |
| 50949 Other procedure on ureter using an endoscope | 249 | 92.0% | 18.37x | 209 | 28 |
| 45499 Other procedure on rectum using an endoscope | 192 | 91.7% | 11.13x | 161 | 26 |
| 99232 Subsequent hospital care with moderate levelof medical decision making, if using | 150 | 82.7% | 23.83x † | 129 | 25 |
| 64999 Other procedure on nervous system | 132 | 97.0% | 33.26x † | 116 | 26 |
| 58571 Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250 | 119 | 84.0% | 34.33x † | 119 | 29 |
| 50715 Release of scar tissue at ureter | 99 | 91.9% | 11.45x | 85 | 35 |
| 58679 Other procedure on fallopian tube or ovary using an endoscope | 88 | 94.3% | 19.32x | 81 | 24.5 |
| 58661 Removal of ovaries and/or tubes using an endoscope | 83 | 96.4% | 28.26x † | 78 | 29 |
| 58999 Other procedure on female genital system (nonobstetrical) | 81 | 90.1% | 26.31x † | 66 | 26 |
| 99238 Hospital discharge day management, 30 minutes or less | 77 | 85.7% | 16.72x | 61 | 25 |
| 44979 Other procedure on appendix using an endoscope | 73 | 98.6% | 382.30x † | 64 | 26 |
| 51999 Other procedure on bladder using an endoscope | 72 | 95.8% | 9.36x | 56 | 29 |
| 59400 Vaginal delivery with care before and after delivery | 71 | 84.5% | 10.79x | 56 | 27 |
| 52000 Diagnostic exam of bladder and urethra using an endoscope | 69 | 92.8% | 65.31x † | 64 | 37 |
| 58545 Removal of growth of uterus using an endoscope, 250.0 g or less | 66 | 87.9% | 18.76x | 65 | 35.5 |
| 58578 Other procedure on uterus using an endoscope | 64 | 93.8% | 21.18x † | 54 | 27.5 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in New York · Obstetrics and gynecology in all states
FAQ
What is the Federal IDR provider win rate for obstetrics and gynecology in New York?
In 2025 Q1–Q4, the provider or facility offer was selected in 90.4% of 4,688 determined dispute line items for obstetrics and gynecology 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 obstetrics and gynecology in New York?
In 2025 Q1–Q4, the median prevailing offer was 30.65x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 10.87x to 78.65x (n = 4,346 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 York?
In 2025 Q1–Q4, the median was 30 business days (n = 4,688 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).