Who is eligible for MIPS 420?

All patients who are treated for varicose veins with saphenous ablation and who receive an outcomes survey within 180 days after treatment.

Is MIPS 420 a topped-out measure?

No, MIPS 420 is not topped out, meaning there is still meaningful performance variation across clinicians.

Measure ID: MIPS 420|Vascular Disease|2026 Performance Year

Varicose Vein Treatment with Saphenous Ablation: Outcome Survey

Percentage of patients treated for varicose veins (CEAP C2-S) who are treated with saphenous ablation (with or without adjunctive tributary treatment) that report an improvement on a disease specific patient reported outcome survey instrument after treatment.

Patient Reported Outcome-Based Performance Measure – High PriorityVascular DiseasePatient-Reported Outcomes

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

All patients, regardless of age

ANDDiagnosis for varicose veins

ANDPatient procedure during the performance period

ORDenominator Exception: Documentation of at least two attempts to follow up with patient within 180 days of treatment (M1463)

ORPerformance Not Met: Patient survey score did not improve from baseline following treatment (G9605)

ORPerformance Not Met: No documentation of at least two attempts to follow up with patient within 180 days of treatment (M1464)

ORPerformance Not Met: Patient follow up more than 180 days after treatment (M1465)

Denominator Exclusions

None

Numerator

Patients whose outcome survey score improved when assessed within 180 days following treatment.

Submission Codes (QDCs)

✓ Performance Met

G9603Patient survey score improved from baseline following treatment

✗ Performance Not Met

G9605Patient survey score did not improve from baseline following treatment

M1464No documentation of at least two attempts to follow up with patient within 180 days of treatment

M1465Patient follow up more than 180 days after treatment

Denominator Exceptions

M1463Denominator Exception: Documentation of at least two attempts to follow up with patient within 180 days of treatment

🧮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

This measure asks whether patients actually feel better after vein ablation surgery for varicose veins, not just whether the veins look better on imaging. Patient quality of life—reduced pain, swelling, and skin changes—is what truly matters for a successful procedure. You'll track symptom improvement using a standardized survey patients complete before and after treatment. Focus on counseling patients about realistic expectations and optimizing your procedural techniques to deliver the best patient outcomes.

📖Clinical Rationale

Surrogate measures to measure the success of varicose vein treatment with saphenous ablation have numerous flaws. The ultimate measure of success of saphenous ablation for varicose veins is an improved quality of life. This quality measure motivates physicians to assess changes in quality of life after as compared with before an ablation using one of several standardized survey instruments.

This enables objective quantification of the improvement in quality of life that saphenous vein ablation provides patients with CEAP C2 disease. Most trials show pain drops fairly quickly but that it plateaus off at about 6 months. There seems to be most improvement by 3 months and some more improvement by 6 months. Therefore, the best time to assess is 3-6 months following treatment (1).

📝Clinical Recommendations

The Intersocietal Accreditation Commission (IAC) - Vein Center Division strongly recommends the use of the disease specific patient reported outcome (PRO) instruments before and after ablation and to use the data collected for an analysis of the quality of care being delivered by the center. These guidelines have been created by the IAC and are being implemented by several groups including Society for Vascular Surgery (SVS).

The American Venous Forum recommends the use of PRO instruments before and after vein treatment for all patients.

📋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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Varicose Vein Treatment with Saphenous Ablation: Outcome Survey

Measure Specification

Denominator (Eligible Population)

Denominator Exclusions

Numerator

Submission Codes (QDCs)

Denominator Exceptions

🧮MIPS Score Simulator

💡Why This Measure Matters

📖Clinical Rationale

📝Clinical Recommendations

📋Implementation Notes

Measure Details

Specialty Sets

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Official Resources

Report this measure through VBCA