Federal IDR outcomes: Vascular surgery in New York
In 2025 Q1–Q4, the provider or facility offer prevailed in 78.6% of 2,049 determined Federal IDR dispute line items for vascular surgery in New York. The median prevailing offer was 34.63x the QPA (25th–75th percentile 5.41x–49.96x; n = 2,016). The median time to a decision was 31 business days (n = 2,049).
Determined line items
2,049
2025 Q1–Q4 · 2 split decisions excluded
Provider win rate
78.6%
n = 2,049 · 2025 Q1–Q4
Median days to decision
31
business days, from dispute initiation · n = 2,049 · 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 | 2,049 | 78.6% | 34.63x † | 5.41x–49.96x | 2,016 | 31 |
| 2024 Q1–Q4 | 185 | 84.3% | 32.43x † | 6.27x–55.74x | 177 | 42 |
| 2023 Q1–Q4 | Fewer than 30 determined line items; not shown. | |||||
| 2023 Q1–2025 Q4 | 2,256 | 79.2% | 34.15x † | 5.43x–51.58x | 2,215 | 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 | 671 | 77.9% | 44.41x † | 659 | 25 |
| 99233 Subsequent hospital care with moderate levelof medical decision making, if using | 642 | 77.3% | 18.83x | 636 | 50 |
| 99497 Advance care planning, first 30 minutes | 194 | 77.3% | 34.95x † | 189 | 35 |
| 99255 Hospital consultation with high level of medical decision making, if using time, | 106 | 70.8% | 29.77x † | 103 | 30.5 |
| 99223 Initial hospital care with moderate level of medical decision making, if using t | 92 | 88.0% | 16.12x | 91 | 35.5 |
| 36475 Destruction of first incompetent vein of arm or leg using radiofrequency and ima | 52 | 86.5% | 87.36x † | 52 | 26 |
| 22558 Fusion of lower spine bone through abdomen with partial removal of disc | 31 | 90.3% | 49.70x † | 30 | 26 |
| 99291 Critical care, first 30-74 minutes | 31 | 61.3% | 16.69x | 30 | 25 |
2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.
Related: all specialties in New York · Vascular surgery in all states
FAQ
What is the Federal IDR provider win rate for vascular surgery in New York?
In 2025 Q1–Q4, the provider or facility offer was selected in 78.6% of 2,049 determined dispute line items for vascular surgery 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 vascular surgery in New York?
In 2025 Q1–Q4, the median prevailing offer was 34.63x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 5.41x to 49.96x (n = 2,016 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 New York?
In 2025 Q1–Q4, the median was 31 business days (n = 2,049 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).