What Cardiology teams should benchmark
Cardiology IDR outcomes are shaped by code mix. The same payer can look fair in one lane and misaligned in another. Start with the codes that dominate your disputed claims, then compare state and payer behavior.
The purpose of this page is to help a specialty leader or RCM team decide where the federal IDR data supports a closer claim-level review.
Top Cardiology service codes
| Code | Service | Disputes | Provider win rate | Median award | Median award dollars |
|---|---|---|---|---|---|
| 93005 | Electrocardiogram (ECG) tracing only, without interpretation | 37,859 | 83.4% | 4.1x | $582 |
| 93010 | Electrocardiogram (ECG) interpretation and report only | 21,105 | 85.6% | 9.4x | $94 |
| 93971 | Duplex ultrasound of extremity veins (clot check), unilateral or limited | 8,683 | 89.9% | 8.0x | $272 |
| 93976 | Duplex ultrasound of abdominal/pelvic blood flow, limited | 4,789 | 91.7% | 6.0x | $492 |
| 93975 | Duplex ultrasound of abdominal/pelvic blood flow, complete | 4,218 | 84.4% | 6.8x | $759 |
| 93970 | Duplex ultrasound of extremity veins (clot check), complete bilateral | 3,167 | 90.9% | 7.9x | $424 |
| 93041 | Rhythm ECG tracing only, 1 to 3 leads, without interpretation | 1,658 | 77.2% | 4.9x | $336 |
| 93880 | Duplex ultrasound of neck arteries (carotid), complete bilateral | 942 | 93.7% | 8.1x | $488 |
Top states for Cardiology disputes
Top payers in Cardiology
| Payer | Disputes | Provider win rate | Median award |
|---|---|---|---|
| BCBSTX | 21,044 | 83.8% | 7.1x |
| UnitedHealthcare | 15,729 | 87.6% | 8.3x |
| Aetna | 12,495 | 91.8% | 7.1x |
| Cigna / MultiPlan | 6,911 | 78.3% | 4.0x |
| UMR | 5,393 | 86.6% | 5.4x |
| Cigna (cigna.com) | 3,623 | 84.1% | 2.7x |
| Anthem Blue Cross | 2,722 | 91.1% | 3.4x |
| BLUE CROSS AND BLUE SHIELD OF ARIZONA | 2,462 | 81.3% | 10.6x |
Open the Cardiology dashboard
Filter the live explorer by state, payer, and year to compare Cardiology outcomes against your own claim mix.
FAQ
How many Cardiology federal IDR disputes are in the dataset?
This benchmark shows 83,809 Cardiology disputes.
What is the Cardiology provider win rate?
The non-default provider win rate is 85.9%.
What should Cardiology groups compare first?
Start with service-code mix, then narrow by payer and state. That sequence usually gives a more useful answer than a national specialty average.
Related benchmarks
Sources and method
- CMS: Federal IDR reports and public use files
- CMS: About Independent Dispute Resolution
- CMS: Federal IDR timeline for claims
Data source: CMS Federal IDR public use files, coverage through 2025Q4; data build 2026-09-21. Counts are CMS dispute counts unless a table says line items. Win rates labeled non-default exclude payer no-show defaults. Award multiples are medians versus QPA. Dollar figures, where shown, are anchored estimates from CMS QPA-and-offer fields, not payment records. This page is informational, not legal or reimbursement advice.