Is MIPS 389 the same as MIPS 389?

Yes. CMS uses zero-padded three-digit Quality IDs (389) in official specifications, while clinicians often search for MIPS 389 or Quality ID 389 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 389: Cataract Surgery: Difference Between Planned and Final Refraction?

Submission codes: G9519 (Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery); G9520 (Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery)

How do I report MIPS Measure 389 in 2026?

MIPS Measure 389 (Quality ID 389) 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 389 a topped-out measure?

No, MIPS 389 is not topped out, meaning there is still meaningful performance variation across clinicians.

Measure ID: MIPS 389|Ophthalmology|2026 Performance Year

2026 MIPS Measure #389: Cataract Surgery: Difference Between Planned and Final Refraction

Percentage of patients aged 18 years and older who had cataract surgery performed and who achieved a final refraction within +/- 1.0 diopters of their planned (target) refraction.

Outcome – High PriorityOphthalmologyPatient Experience

Measure ID:MIPS 389 (Quality ID 389)

Collection:MIPS CQM

Topped Out:No

View CMS Spec ↗

Measure Specification

Eligible Population

Patients aged ≥ 18 years on date of encounter

ANDPatient procedure during the performance period

WITHOUTModifier: 55 or 56

Exclusions

None

Numerator

Patients who achieved a final refraction (spherical equivalent) of +/- 1.0 diopters of their planned (target) refraction (spherical equivalent) within 90 days following cataract surgery. The refraction planned and final refraction values should correspond to the eye that underwent the cataract procedure. _NUMERATOR NOTE:_ It would be expected that the planned (target) refraction be assessed and documented within 90 days prior to the denominator eligible procedure.

Reporting Codes

Performance Met:

G9519Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

Performance Not Met:

G9520Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

VBCA Insights

Why This Measure Matters

After cataract surgery, did the patient's final refraction (glasses prescription) land within +/- 1 diopter of the planned target? This is a direct measure of surgical precision—how well you predicted and achieved the desired refractive outcome. Good performance reflects careful pre-op biometry, correct IOL power selection, and stable postoperative healing. Patients notice the difference between 'good enough' and hitting the target; achieving the planned refraction dramatically boosts satisfaction and reduces the need for revision.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 389 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

Ophthalmology

Related Measures

Ophthalmology

MIPS 117: Diabetes: Eye Exam MIPS 141: Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 20% OR MIPS 191: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery MIPS 303: Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract MIPS 304: Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery 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 499: Appropriate Screening and Plan of Care for Elevated Intraocular Pressure Following MIPS 500: Acute Posterior Vitreous Detachment Appropriate Examination and Follow-up MIPS 501: Acute Posterior Vitreous Detachment and Acute Vitreous Hemorrhage Appropriate

Patient Experience

MIPS 304: Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery MIPS 430: Prevention of Post-Operative Nausea and Vomiting (PONV) – Combination Therapy

Official Resources

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

Clinical Rationale

Refractive outcome is important to the patient and to the surgeon. Planned refraction is something the surgeon and patient discuss at the time of assessment for cataract surgery and is a way to align patient and surgeon expectations of the outcome. The surgeon should consider the patient’s desires and needs when selecting a postoperative refractive target outcome.

Comparing actual outcome to predicted outcome is a valuable measure of success. Results of multiple large studies of cataract surgery have repeatedly demonstrated positive outcomes. The ASCRS National Cataract Database reported that at 3 months postoperatively 74.6% of patients were within ±1.0 D of target spherical equivalent. The American Academy of Ophthalmology National Eyecare Outcomes Network (NEON) database also found similar rates of success, with 78% of patients within ± 1.

0 D of target spherical equivalent. Kugelberg and Lundstrom published outcomes data from the Swedish registry and found in routine cataract surgeries 75% to 90% of patients ended up with refraction within 1 diopter of the target refraction. The study describes factors that influenced refractive outcome as older age and use of a clear corneal incision.

Another 2009 study by Gale and colleagues reported outcomes improving from 79.7% to 87% within 3 measurement cycles and the authors suggested that a benchmark standard of 85% be established. The European Society of Cataract and Refractive Surgeons femtosecond laser-assisted cataract surgery (FLACS) study compared 2814 consecutive cases from high-volume surgeons with 4987 control patients matched by characteristics such as age, preoperative CDVA, ocular comorbidities, and surgical comorbidities from the 2014 European Registry of Quality Outcomes for Cataract and Refractive Surgery.

The mean refractive error was 0.40 D versus 0.43 D for FLACS, P < 0.05, with 74.3% of control eyes being within 0.5 D and 94.1% being within 1 D of target.

Clinical Recommendations

This is an outcome measure. As such, no clinical recommendations are included.

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. This is an outcome measure and will be calculated solely using Merit-based Incentive Payment System (MIPS) eligible clinician, group, or third-party intermediary submitted data.

• For patients who receive the surgical procedures specified in the denominator coding, it should be reported whether or not the patient had a difference between planned and final refraction. • Include only procedures performed between January 1st and September 30th of the performance period. This will allow the post-operative period to occur before third-party intermediaries must submit data to CMS.

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