Who is eligible for MIPS 259?

All endovascular repairs of non-ruptured, infrarenal abdominal aortic aneurysms.

Is MIPS 259 the same as MIPS 259?

Yes. CMS uses zero-padded three-digit Quality IDs (259) in official specifications, while clinicians often search for MIPS 259 or Quality ID 259 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

How do I report MIPS Measure 259 in 2026?

MIPS Measure 259 (Quality ID 259) 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 259 a topped-out measure?

No, MIPS 259 is not topped out, meaning there is still meaningful performance variation across clinicians.

Measure ID: MIPS 259|Vascular Surgery|2026 Performance Year

2026 MIPS Measure #259: Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured

Percent of patients undergoing endovascular repair of small or moderate non-ruptured infrarenal abdominal aortic aneurysms (AAA) that do not experience a major complication (discharged to home no later than post-operative day #2).

Outcome – High PriorityVascular SurgeryPatient Safety

Measure ID:MIPS 259 (Quality ID 259)

Collection:MIPS CQM

Topped Out:No

View CMS Spec ↗

Measure Specification

Eligible Population

Patients aged ≥ 18 years on date of encounter

ANDDiagnosis for non-rupture, infrarenal abdominal aortic aneurysms on date of encounter

ANDPatient procedure during the performance period

Exclusions

For women: Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline formatted CT or minor diameter on axial formatted CT: 9003F

Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted CT or minor diameter on axial formatted CT: 9004F

For men: Aortic aneurysm 6.0 cm or greater maximum diameter on centerline formatted CT or minor diameter on axial formatted CT: 9004F

Numerator

Patients discharged to home no later than post-operative day #2 following EVAR of AAA.

Reporting Codes

Performance Met:

G8826Patient discharged to home no later than post-operative day #2 following EVAR

Performance Not Met:

G8833Patient not discharged to home by post-operative day #2 following EVAR

VBCA Insights

Why This Measure Matters

Endovascular AAA repair is less invasive than open surgery, but patients should still go home quickly without major complications. This outcome measure tracks the percentage of EVAR patients discharged to home by post-op day 2. Good performance reflects careful patient selection, smooth perioperative management, and rapid recovery. If your discharge rate lags, review patient factors (frailty, comorbidities) and perioperative protocols to identify improvement opportunities.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 259 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

Vascular Surgery

Related Measures

Vascular Surgery

MIPS 344: Rate of Carotid Endarterectomy (CEA) or Carotid Artery Stenting (CAS) for

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 168: Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration MIPS 181: Elder Maltreatment Screen and Follow-Up Plan 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

Elective repair of a small or moderate sized AAA is a prophylactic procedure and the mortality/morbidity of the procedure must be contrasted with the risk of rupture over time. Surgeons should select patients for intervention who have a reasonable life expectancy and who do not have a high surgical risk. Discharge to home within two days of endovascular AAA repair is an indicator of patients who were not frail prior to the procedure and who did not experience a major complication.

The proposed measure will therefore serve as an indicator of both appropriateness and overall outcome.

Clinical Recommendations

Elective repair is recommended for patients that present with a fusiform AAA ≥ 5.5 cm in maximum diameter, in the absence of significant comorbidities. Level of recommendation: Strong Quality of evidence: High Surveillance is recommended for most patients with a fusiform AAA in the range of 4.0 cm to 5.4 cm in maximum diameter. Level of recommendation: Strong Quality of evidence: Moderate

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. The most recent quality data code will be used if the measure is submitted more than once.

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