CPT® 2026: The Wait Is Over

Time to update documentation, charge capture, code edits, and payer policies.

It’s that special time of year, when we get our shiny, new code books. Oh, the anticipation of what’s inside! The CPT® 2026 update includes 418 changes — 288 new codes, 46 revised codes, 84 deleted codes — and refines guidance across multiple sections. It’s like the gift that keeps giving.

Notable shifts include new hearing device services, a comprehensive rebuild of lower-extremity revascularization, expanded recognition of digital health (including shorter-duration remote monitoring), and growth in clinician-directed artificial intelligence and assistive analytics. There is also activity in radiology and pathology/laboratory.

This latest full update to the American Medical Association’s procedural code set takes effect Jan. 1, 2026. Join me as I review the changes and highlight what you need to know to ensure correct coding and proper claims payment for your organization.

Evaluation and Management

In the evaluation and management (E/M) section of CPT® 2026, code descriptors for remote physiologic monitoring (99453 and 99454) are revised and a new code (99445) is available for reporting the supply of the device and daily recording or programmed transmission for two to 15 days in a 30-day period. Be sure to read the new guidelines and parentheticals for these codes.

Another new code (99470) is added for the first 10 minutes of remote physiologic monitoring treatment. Codes 99457 and 99458 are revised as a result of 99470. This family of codes also includes new guidelines, a table illustrating proper coding based on time, and new parenthetical notes.

Surgery: Integumentary System

CPT® 2026 includes one code revision in the Integumentary System section. Code 10040 is revised to replace “Acne surgery” with “Extraction.”

Surgery: Musculoskeletal System

In the Musculoskeletal System section, you will find an editorial revision to arthrodesis codes 27278 and 27279. Sacroiliac (SI) joint arthrodesis language and related parenthetical notes are updated to better reflect current approaches, including hybrid SI fusion constructs that combine percutaneous implants with decortication or grafting.

Also in this section are two new reconstruction codes: 27458 describes a unilateral femoral osteotomy with placement of an externally controlled intramedullary lengthening device; and 27713 describes a unilateral tibial osteotomy with insertion of an externally controlled intramedullary lengthening device. The physician’s work to plan and manage the lengthening process is included in both codes.

Surgery: Cardiovascular System

In the Cardiovascular System section, CPT® 2026 includes new guidelines and several code changes for endovascular repair of the thoracic aorta. Codes 33880, 33881, 33883, and 33886 are revised; 33884, 33889, 33891 are deleted; and 33882 is added. This code family reports thoracic endovascular aortic repair procedures that treat disease of the aortic arch and descending thoracic aorta using stent graft systems.

The lower extremity revascularization family is rebuilt for calendar year (CY) 2026. The long-standing codes are deleted and replaced with 46 territory-based codes (37254-37299). The new framework defines four vascular regions for reporting iliac, femoral and popliteal, tibial and peroneal, and inframalleolar. Within each region, the codes distinguish straightforward lesions from complex lesions and use clearer add-on logic when additional vessels are treated.

Surgery: Digestive System

A new code in the Digestive System section, 43889, is added to report endoscopic sleeve gastroplasty for gastric restriction. Also added is code 47384, which describes percutaneous liver tumor ablation using irreversible electroporation for one or more lesions and includes the required imaging guidance.

Surgery: Urinary System

In the Urinary System section of CPT® 2026, you’ll find a new code, 52443, for cystourethroscopic treatment of a benign prostatic obstruction that combines two balloon steps. First, an anterior prostate commissurotomy is performed to open the prostatic urethra using a nondrug-coated balloon. Second, a drug-coated balloon is inserted to deliver a therapeutic agent into the prostate.

Another new code, 52597, describes a transurethral, robotic-assisted waterjet resection of the prostate for benign prostatic obstruction.

Surgery: Male Genital System

CPT® 2026 restructures prostate biopsy reporting. The update deletes 55700 and introduces 55707-55714 for reporting biopsy of the prostate by approach and use of imaging. You will report targeted biopsies once per lesion rather than by the number of cores; and 55715 is added to report each additional targeted lesion when fusion or in-bore techniques are used. Diagnostic ultrasonography performed at the same session is included with the ultrasound-guided and fusion codes listed in the new guidelines.

Also in this section, 55866 was revised to become a parent code to two new codes:

• 55868 – Use this code to report lymph node biopsy(ies) when performed during a radical retropubic laparoscopic prostatectomy.
• 55869 – Use this code to report bilateral pelvic lymphadenectomy when performed during a radical retropubic laparoscopic prostatectomy.

Surgery: Nervous System

Transcatheter vascular occlusion or embolization codes 61624 and 61626 are revised to include all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention.

New code 62330 reports bilateral percutaneous lumbar decompression with partial removal of the ligamentum flavum at one interspace. The work includes a limited laminotomy for access, epidurography, and imaging guidance with CT or fluoroscopy. Report new add-on code +62331 for each additional lumbar interspace treated in the same session.

A new family of codes describes autonomic nervous system modulation, which is baroreflex activation therapy (BAT) for resistant hypertension or heart failure using a system with a carotid sinus lead connected to a subcutaneous pulse generator. The new codes are:

• 64654 describes the initial open implantation of a BAT system, including carotid sinus lead placement, tunneling, pulse generator placement, connection, and intraoperative interrogation and programming.
• 64655 reports revision or replacement of the BAT system lead only, with intraoperative interrogation and programming included.
• 64656 reports revision or replacement of the BAT system pulse generator only, with intraoperative interrogation and programming included.
• 64657 describes removal of the entire BAT system, including both the carotid lead and the pulse generator.
• 64658 describes removal of the BAT system lead only.
• 64659 describes removal of the BAT system pulse generator only.

Report interrogation and programming performed on a separate date with new code 93145 or 93146. Otherwise, interrogation and programming during implantation, revision, replacement, or removal are included in 64654-64657.

Radiology

In the Radiology section of CPT® 2026, new code 70471 reports computed tomographic angiography (CTA) of the head and neck with contrast and bundles images without the use of contrast, when performed, and all image postprocessing performed in the same session. New add-on code +70472 describes CT cerebral perfusion when it is performed in the same session as a head CT or head and neck CTA of the same anatomy. New code 70473 reports CT cerebral perfusion when it is performed without a concurrent head CT or head and neck CTA of the same anatomy. Do not report 70473 with the CT/CTA codes or with 3D postprocessing codes.

CPT® 2026 also revises daily external-beam delivery into three levels and folds image guidance into the delivery codes. Existing radiation treatment delivery codes 77402, 77407, and 77412 are revised to represent Levels 1, 2, and 3, with guidance and motion management bundled as part of delivery when performed. Intensity modulated radiation treatment (IMRT) delivery codes 77385 and 77386 and CT image-guidance code 77014 are deleted because their work is now captured in the revised delivery family.

A new code family, with guidelines, is added for surface radiation therapy:

• 77436 reports surface radiation therapy planning for superficial or orthovoltage treatments, including simulation-aided field setting for cutaneous targets.
• 77437 reports superficial radiation treatment delivery at up to 150 kV per fraction.
• 77438 reports orthovoltage radiation treatment delivery greater than 150 kV and up to 500 kV per fraction.
• +77439 is an add-on code for ultrasound image guidance used to place superficial or orthovoltage treatment fields for cutaneous tumors. Report this code once per course of treatment and only with 77437 or 77438.

A new radiation management and treatment table clarifies how to use these new codes.

Pathology and Laboratory

New molecular pathology code 81354 reports genome-wide cytogenomic analysis using optical genome mapping to detect structural and copy number variants.

New multianalyte assays with algorithmic analyses (MAAA) code 81524 is for DNA methylation profiling for central nervous system tumors using a large methylation array that assays at least 10,000 sites from formalin-fixed tumor tissue. Results are generated by algorithmic comparison to a reference classifier and are reported as the probability that the tumor matches a specific family and class.

Chemistry codes 83015 and 83018 are revised to include antimony and gadolinium as examples of heavy metals that testing may detect.

There are five new microbiology codes for carbapenemase enzyme detection (87182), carbapenem resistance genes (87183), chlamydia trachomatis and Neisseria gonorrhoeae (87494), joint space pathogens and drug resistant genes (87627), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) and influenza virus types A and B (87812).

There are also many new proprietary laboratory analyses (PLA) codes (0521U-0599U). These codes describe PLAs provided by either a single laboratory or licensed/marketed to multiple providing laboratories. This subsection includes MAAA and genomic sequencing procedures (GSP).

Medicine

New respiratory syncytial virus vaccine product code 90382 is for a seasonal dose of 0.7 mL. There are also new influenza vaccine codes: 90631, 90635, 90612, and 90613.

Administration code 90480 is revised to clarify its use for reporting the first or only component of each vaccine. Use new add-on code +90481 to report each additional component. Three new vaccination counseling codes, 90482-90484, enable you to report counseling when it is not performed on the same date as the vaccine administration. These counseling codes are time-based.

Hearing device services in CY 2026 replace the long-standing 92590-92595 codes with a modern time-based framework that follows the full care pathway. The new family of 12 codes (92628-92642) cover candidacy evaluation, device selection, initial fitting, post-fitting follow-up, and verification methods such as probe-microphone and electroacoustic checks, plus fitting of supplemental assistive technologies. Time tiers let you report the intensity of work with add-on units for longer visits; and verification services are separately reportable when performed.

The Coronary Therapeutic Services and Procedures subsection (92920-92945) is revamped: You’ll find new guidelines and the revision of eight codes, deletion of six codes, and addition of two new codes (92930 and 92945). The add-on codes that reported “each additional branch of a major coronary artery” for the percutaneous coronary intervention procedures are deleted and the base codes (92933, 92937, 92941, and 92943) are revised to specify a “single major coronary artery and its branches.” If procedures are performed on more than one major coronary artery, report each base code that describes the most intensive intervention performed (angioplasty, stents, atherectomy).

Category III Codes

There are many new Category III codes created for new and emerging technologies. Some examples include new codes 0951T-0955T for totally implantable active middle ear hearing implant, 0970T-0971T for ablation of breast tumors, and 1004T-1009T for implantable sub-scalp continuous bilateral electroencephalography monitoring.