Measure ID: MIPS 344|Vascular Surgery|2026 Performance Year

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

Percent of asymptomatic patients undergoing Carotid Endarterectomy (CEA) or Carotid Artery Stenting (CAS) without major complication who are discharged to home no later than post-operative day #2.

Outcome – High PriorityVascular SurgeryStroke Prevention

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

Patients aged 18 years and older
ANDPatient procedure during performance period

Denominator Exclusions2

Symptomatic carotid stenosis: Ipsilateral carotid territory TIA or stroke less than 120 days prior to procedure: 9006F
Other carotid stenosis: Ipsilateral TIA or stroke 120 days or greater prior to procedure or any prior contralateral carotid territory or vertebrobasilar TIA or stroke: 9007F

Numerator

Patients discharged to home no later than post-operative day 2 following CEA or CAS.

Submission Codes (QDCs)

✓ Performance Met
G9255Documentation of patient discharged to home no later than post-operative day 2 following CEA or CAS
✗ Performance Not Met
G9254Documentation of patient discharged to home later than post-operative day 2 following CEA or CAS

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

Carotid artery surgery (CEA or stenting) in asymptomatic patients—those without stroke history—is only worthwhile if done with very low complication rates on carefully selected, non-frail patients. This measure checks whether patients with no major complications go home by day 2, signaling they were low-risk and the surgery went smoothly. If you're keeping them longer or having complications, either your patient selection is too aggressive or your technique needs review. Be selective and precise.

📖Clinical Rationale

Surgeons performing CEA or CAS on asymptomatic patients must select patients at low risk for morbidity and perform the procedure with a very low complication rate in order to achieve benefit. Discharge to home within two days of the procedure is an indicator of patients who were not frail prior to the procedure and who did not experience a major complication (e.

g., disabling stroke, myocardial infarction). The proposed measure will therefore serve as an indicator of both appropriateness and overall outcome.

📝Clinical Recommendations

The committee recommends CEA as the first-line treatment for symptomatic low-risk surgical patients with stenosis of 50% to 99% and asymptomatic patients with stenosis of 70% to 99%. The perioperative risk of stroke and death in asymptomatic patients must be <3% to ensure benefit for the patient.

📋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.

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