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The Merit-Based Incentive Payment System (MIPS) is the default Quality Payment Program (QPP) participation pathway for most surgeons. MIPS is composed of four performance categories, which contribute a specified weight to the overall MIPS final score:

• Quality
• Cost
• Improvement Activities
• Promoting Interoperability

• In 2025, surgeons will have to score a total of at least 75 overall MIPS points to avoid a payment penalty.
• Surgeons can receive positive, neutral, or negative payment adjustments based on their MIPS final score. The maximum negative payment adjustment in 2025 is 9 percent. Because payment adjustments are budget neutral, and relatively few MIPS-eligible clinicians have been subject to MIPS penalties to date, the maximum positive payment adjustment has rarely exceeded 2 percent. If a surgeon is eligible for MIPS in 2025 and chooses not to, they would receive the full -9 percent Medicare payment adjustment in 2027.
• Each MIPS performance category contributes a specific weight to the MIPS final score. See all four category weights for 2025 below:

Surgeons seeking assistance in planning for 2025 QPP and MIPS participation should email QualityDC@facs.org.