Measure ID: MIPS 168|Cardiac Surgery|2026 Performance Year

Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration

Percentage of patients aged 18 years and older undergoing isolated coronary artery bypass graft (CABG) surgery who require a return to the operating room (OR) for mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native vessel, graft or both), valve dysfunction, aortic reintervention or other cardiac reason during the current hospitalization.

Outcome – High PriorityCardiac SurgeryPatient Safety

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
ORPerformance Met: Re-exploration required due to mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native vessel, graft or both), valve dysfunction, aortic reintervention, or other cardiac reason (G8577)

Denominator Exclusions

None

Numerator

Patients undergoing isolated CABG surgery who require a return to the OR for mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native vessel, graft or both), valve dysfunction, aortic reintervention or other cardiac reason during the current hospitalization.

Submission Codes (QDCs)

✓ Performance Met
G8577Re-exploration required due to mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native vessel, graft or both), valve dysfunction, aortic reintervention, or other cardiac reason
✗ Performance Not Met
G8578Re-exploration not required due to mediastinal bleeding with or without tamponade, unplanned coronary artery intervention (native vessel, graft or both), valve dysfunction, aortic reintervention, or other cardiac reason

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

Reoperation after bypass surgery for bleeding, clotting issues, or valve problems is a major setback that extends hospitalization and raises complications. This outcome measure tracks how many of your bypass patients avoid returning to the OR. Lower rates reflect sound surgical technique, proper anticoagulation protocols, and vigilant post-operative monitoring. Building a culture of early recognition and conservative management of post-op bleeding can significantly improve this metric.

📖Clinical Rationale

In 2000, CABG surgery was performed on more than 350,000 patients at a cost of close to $20 billion. Re-exploration after surgery is a serious complication that impacts length of stay, efficient use of resources, and increases risk for additional complications and death. As one of several major complications of cardiac surgery, repeat surgery is particularly worrisome for consumers and is an inefficient use of resources.

📝Clinical Recommendations

Re-exploration after surgery is a serious complication that impacts length of stay, efficient use of resources, and increases risk for additional complications and death. This measure is currently in use by approximately 65% of providers in the United States who perform cardiac surgery and report data to the Society of Thoracic Surgeons (STS) National Database.

📋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.

Measure Details

MIPS 168View CMS Spec ↗
Year2026
TypeOutcome
PriorityHigh Priority
InverseYes
Topped OutNo
7-Point CapNo
SubmissionMIPS CQM

Specialty Sets

CMS-designated specialty sets containing this measure:

Thoracic Surgery (10)

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Door to Puncture Time for Endovascular Stroke Treatment

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Official Resources

📄 CMS Measure Specification (PDF)🔗 QPP Quality Payment Program

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© This measure is owned by The Society of Thoracic Surgeons (STS). Copyright 2025.