2026 MIPS Measure #344: Rate of Carotid Endarterectomy (CEA) or Carotid Artery Stenting (CAS) for Asymptomatic Patients, Without Major Complications (Discharged to Home by Post-Operative Day #2)

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.

This measure is to be submitted each time a CEA or CAS is performed during the performance period. It is anticipated that Merit-based Incentive Payment System (MIPS) eligible clinicians who provide services of CEA or CAS, as described in the measure, based on the services provided and the measure-specific denominator coding will submit this measure.This measure may be submitted by MIPS eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Patients aged 18 years and older who are asymptomatic undergoing a CEA or CAS procedure

DENOMINATOR NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for MIPS CQMs.

Patients aged 18 and older

AND

Patient procedure during performance period (CPT): 35301, 37215, 37216*

AND NOT

DENOMINATOR EXCLUSIONS:

Symptomatic carotid stenosis: Ipsilateral carotid territory TIA or stroke less than 120 days prior to procedure: 9006F

OR

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

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

Home – For purposes of submitting this measure, “home” is the point of origin prior to hospital admission for procedure of CEA or CAS. For example, if the patient comes from a skilled facility and returns to the skilled facility post CEA or CAS, this would meet criteria for discharged to home.

Performance Met: Documentation of patient discharged to home no later than post-operative day 2 following CEA or CAS (G9255)

OR

Performance Not Met: Documentation of patient discharged to home later than post-operative day 2 following CEA or CAS (G9254)

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.

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