Who is eligible for MIPS 168?

All patients undergoing isolated CABG surgery.

Is MIPS 168 the same as MIPS 168?

Yes. CMS uses zero-padded three-digit Quality IDs (168) in official specifications, while clinicians often search for MIPS 168 or Quality ID 168 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

What codes do I submit for MIPS 168: Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration?

Submission codes: G8577 (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); G8578 (Re-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)

How do I report MIPS Measure 168 in 2026?

MIPS Measure 168 (Quality ID 168) is reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM) via qualified registry, or Medicare Part B claims where applicable.

Is MIPS 168 a topped-out measure?

No, MIPS 168 is not topped out, meaning there is still meaningful performance variation across clinicians.

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

2026 MIPS Measure #168: 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

Measure ID:MIPS 168 (Quality ID 168)

Collection:MIPS CQM

Topped Out:No

View CMS Spec ↗

Measure Specification

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

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.

Reporting Codes

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

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.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 168 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM) or through qualified registry submission.

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Specialty Measure Sets

Thoracic Surgery

Related Measures

Cardiac Surgery

MIPS 164: Coronary Artery Bypass Graft (CABG): Prolonged Intubation MIPS 167: Coronary Artery Bypass Graft (CABG): Postoperative Renal Failure MIPS 445: Risk-Adjusted Operative Mortality for Coronary Artery Bypass Graft (CABG)

Patient Safety

MIPS 130: Documentation of Current Medications in the Medical Record MIPS 145: Radiology: Exposure Dose Indices Reported for Procedures Using Fluoroscopy MIPS 155: Falls: Plan of Care MIPS 164: Coronary Artery Bypass Graft (CABG): Prolonged Intubation MIPS 181: Elder Maltreatment Screen and Follow-Up Plan MIPS 259: Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured MIPS 275: Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before MIPS 286: Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia MIPS 351: Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular Risk MIPS 354: Anastomotic Leak Intervention MIPS 355: Unplanned Reoperation within the 30-Day Postoperative Period MIPS 357: Surgical Site Infection (SSI)MIPS 374: Closing the Referral Loop: Receipt of Specialist Report MIPS 384: Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating MIPS 385: Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement MIPS 392: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation MIPS 393: Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation,MIPS 413: Door to Puncture Time for Endovascular Stroke Treatment MIPS 422: Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse MIPS 432: Proportion of Patients Sustaining a Bladder or Bowel Injury at the time of any Pelvic MIPS 513: Patient Reported Falls and Plan of Care

Official Resources

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

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.

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