MIPS Cost Performance Category

30% of your MIPS Performance Score

Our system captures 25 essential measures from claims data, including 15 episode-based measures, 6 acute-episode measures, and 2 chronic care episode measures.

Track your MIPS Cost performance over a full calendar year with our system's Total Category Score calculation, which averages the score of all applicable measures

Stay ahead of the curve with quarterly performance previews through
MIPSpro Enterprise or Healthmonix MIPS Cost Analytics.

Need to know for 2023
MIPS Cost Reporting

  • If a clinician or group does not meet the minimum number of cases for any of the cost measures, the cost category will be re-weighted.
  • The most common applicable cost measures are Total Per Capita Cost (TPCC) and Medicare Spending Per Beneficiary (MSPB).
  • CMS calculates a single, national benchmark for each cost measure based on the performance year. All MIPS-eligible clinicians who meet or exceed the minimum number of cases for a measure are included in the same benchmark.
  • Cost Performance is 30% of your final score

Use the dropdown menu below to view Cost measures & Specs

2023 MIPS Cost Measures

Measure Topic

Measure Type

 Evaluates Risk Adjustment Cost 


Medicare Spending Per Beneficiary (MSPB)

All Patient

Specific procedure provided during an inpatient stay

Total Per Capita Costs (TPCC)

All Patient

Overall cost of care provided to patients

Routine Cataract Removal with Intraocular Lens (IOL) Implantation


Undergo a procedure for routine cataract removal with intraocular lens implantation 

Asthma/Chronic Obstructive
Pulmonary Disease (COPD)

Chronic Condition

Patients receiving medical care to manage and treat asthma or COPD

Colon and Rectal Resection 


Receive colon or rectal resection for either benign or malignant indications during the performance period.


Chronic Condition

Receiving medical care to manage and treat diabetes.

Intracranial Hemorrhage or Cerebral Infraction

Acute Inpatient Medical Condition

Receive inpatient treatment for cerebral infarction or intracranial hemorrhage during the performance period.

Melanoma Resection


Undergo an excision procedure to remove a cutaneous melanoma during the performance period.

Knee Arthroplasty


Patients who receive an elective knee arthroplasty during the performance period.

Elective Outpatient Percutaneous
Coronary Intervention (PCI)


Undergo elective outpatient PCI surgery to place a coronary stent for heart disease during the performance period.

Simple Pneumonia with Hospitalization

Acute Inpatient Medical Condition

Patients who receive inpatient treatment for simple pneumonia during the performance period.

Revascularization for Lower Extremity
Chronic Critical Limb Ischemia


Undergo elective revascularization surgery for lower extremity chronic critical limb ischemia.

Screening/Surveillance Colonoscopy


Undergo a screening or surveillance colonoscopy procedure during the performance period.

ST-Elevation Myocardial Infarction (STEMI)
with Percutaneous Coronary Intervention (PCI)

Acute Inpatient Medical Condition

Present with STEMI indicating complete blockage of a coronary artery who emergently receive PCI as treatment


Acute Inpatient Medical Condition

Patients who receive inpatient medical treatment for sepsis during the performance period.

Renal or Ureteral Stone Surgical Treatment


Receive surgical treatment for renal or ureteral stones during the performance period.

Non-Emergent Coronary
Artery Bypass Graft (CABG)


Patients who undergo a CABG procedure during the performance period.

Lumpectomy, Partial Mastectomy,
Simple Mastectomy


Undergo partial or total mastectomy for breast cancer during the performance period.

Lower Gastrointestinal Hemorrhage 

Acute Inpatient Medical Condition

Receive inpatient non-surgical treatment for acute bleeding in the lower gastrointestinal tract

Lumbar Spine Fusion for
Degenerative Disease, 1-3 Levels


Undergo surgery for lumbar spine fusion during the performance period.

Inpatient Chronic Obstructive
Pulmonary Disease (COPD) Exacerbation

Acute Inpatient Medical Condition

Receive inpatient treatment for an acute exacerbation of COPD during the performance period.

Hemodialysis Access Creation


Undergo a procedure for the creation of graft or fistula access for long-term hemodialysis

Femoral or Inguinal Hernia Repair


Undergo a surgical procedure to repair a femoral or inguinal hernia during the performance period.

Elective Primary Hip Arthroplasty


Receive an elective primary hip arthroplasty during the performance period.

Acute Kidney Injury Requiring
New Inpatient Dialysis


Receive an inpatient dialysis service for acute kidney injury during the performance period.

MIPS Cost Analytics is the next big thing in Cost tracking. 

Learn how we can help you achieve your revenue goals and improve care.

Licenses are available for the 2023 reporting year.