Measure ID: MIPS 167|Cardiac Surgery|2026 Performance Year

Coronary Artery Bypass Graft (CABG): Postoperative Renal Failure

Percentage of patients aged 18 years and older undergoing isolated coronary artery bypass graft (CABG) surgery (without pre-existing renal failure) who develop postoperative renal failure or require dialysis.

Outcome – High PriorityCardiac SurgeryNephrology

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

All patients aged 18 years and older on date of surgery
ANDPatient procedure during the performance period
ORPatient procedure during the performance period
ANDPatient procedure during the performance period

Denominator Exclusions1

G9722Documented history of renal failure or baseline serum creatinine ≥ 4.0 mg/dL; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the Cr has been or is 4.0 or higher

Numerator

Patients who develop postoperative renal failure or require dialysis.

Submission Codes (QDCs)

✓ Performance Met
G8575Developed postoperative renal failure or required dialysis
✗ Performance Not Met
G8576No postoperative renal failure/dialysis not required

Denominator Exceptions

None — this measure has no denominator exceptions.

🧮MIPS Score Simulator

Estimate only — actual CMS scoring may vary based on reporting method, data completeness, and annual rule updates.

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VBCA Insights

💡Why This Measure Matters

Kidney injury after bypass surgery is a rare but serious complication that drives up mortality and cost dramatically—yet it's often preventable. This measure counts patients who develop acute renal failure or need dialysis post-bypass. Focus on preserving kidney function through careful fluid management, monitoring contrast exposure, and optimizing blood pressure during and after surgery. Patients with pre-existing kidney disease require even closer perioperative attention.

📖Clinical Rationale

In 2000, CABG surgery was performed on more than 350,000 patients at a cost of close to $20 billion. Some degree of Acute Renal Dysfunction (ARD) occurs in about 8% of patients following CABG, and dialysis-dependent renal failure occurs in 0.7% to 3.5% of patients receiving CABG. The latter is associated with substantial increases in morbidity, length of stay, and mortality (odds ratios for mortality range from 15 to 27).

ARD is associated with increased morbidity, mortality and length of stay in an ICU following surgery. In addition, Acute Renal Failure occurs in 1.5% of patients undergoing any type of cardiac surgery. There has been a substantial increase in postoperative morbidity, mortality, and cost associated with this relatively common complication, regardless of whether or not this incidence varies much between providers, and there are implications of even a modest decrease in its incidence.

📝Clinical Recommendations

Acute Renal Failure following CABG is an intermediate outcome measure for mortality since this complication is independently associated (OR=27) with early mortality following cardiac surgery, even after adjustment for co-morbidity and postoperative complications.

📋Implementation Notes

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this procedure measure is submitted each time a procedure is performed during the performance period. This is an inverse measure which means a lower calculated performance rate for this measure indicates better clinical care or control.

The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.

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© This measure is owned by The Society of Thoracic Surgeons (STS) Copyright 2024.