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Each year, CPT® (Jan 1) and ICD-10 (Oct for ICD-10-CM®) updates impact code selection, reporting of services, and reimbursement. This page summarizes the major update areas and will point you to official resources for deeper review.

CPT Changes for 2026

(Effective Jan 1, 2026)

Changes made include:

Evaluation and Management:

  • 99453 and 99454 revised

  • 99445 added

Surgery: Integumentary

  • 10040 revised (“Acne Surgery” > “Extraction”)

Surgery: Cardiovascular System

  • 33880, 33881, 33883, and 33886 revised

  • 33884, 33889, 33891 deleted

  • 33882 added

  • Lower extremity revascularization CPT family rebuilt; long standing codes replaced with territory-based codes (372564-37299)

Surgery: Digestive System

  • 43889 added

  • 47384 added

Surgery: Urinary System

  • 52443 added

  • 52597 added

Surgery: Male Genital System

  • 55700 deleted; 55707-55714 added

  • Report targeted biopsies once per lesion rather than number of cores

  • 55715 added

  • 55866 revised; 55868, 55869 added

Surgery: Nervous System

  • 61624 and 61626 revised

  • 62330 and +62331 added

  • New family of codes to describe ANS modulation (BAT); 64654-64659 added

    • interrogation and programming performed on a separate date is reported with new codes 93145 or 93146; otherwise included on same day with 64654-64657

Radiology

  • 70471, +70472, and 70473 added

  • 77402, 77407, 77412 revised

  • 77385, 77385, 77014 deleted

  • New code family, including guidelines, added for surface radiation therapy; 77436, 77437, 77438, and +77439 added

Pathology and Laboratory

  • 81354 added

  • 81524 added

  • 83015 and 83018 revised

  • 87182, 87183, 87494, 87627, and 87812 added

  • Many new proprietary laboratory analyses (PLA) codes (0521U-0599U)

Medicine

  • 90382 added

  • New influenza vaccine codes; 90631, 90635, 90612, and 90613 added

  • 90480 revised

  • +90481, 90482-90484 added

  • 92590-92595 deleted; New family of 12 codes (92628-92642) added for hearing device services

  • Coronary Therapeutic Services (92920-92945): eight revisions, six deletions, two new codes (92930 and 92945)

  • 92933, 92937, 92941, and 92943 revised to specify “single major artery and its branches”; add-on codes that reported “each additional branch of a major coronary artery” have been deleted

https://www.aapc.com/blog/93606-cpt-2026-the-wait-is-over/?srsltid=AfmBOoqbBGKnpFflboLs8UC8soH1sNVWy4c7Y12wx6OuZQbLVKvkGqps

  • New codes for shorter duration remote monitoring

  • New codes for augmentative and assistive AI services

  • New codes for hearing device services

  • Code overhaul for leg revascularization

  • Appendixes updated

https://www.ama-assn.org/press-center/ama-press-releases/ama-releases-cpt-2026-code-set

ICD-10-CM Changes for 2026

(FY 2026 - Eff Oct 1, 2025)

Changes made include:

HIV Reporting

  • One new guideline (I.C.1.a.2.a - HIV Disease) was added to HIV section, and eight other have been edited. The additions and wording changes provide clarification without changing the coding principals outright.

Endocrine, Nutritional and Metabolic Diseases

  • Four new subcategories added: E72.53, E72.54, E78.01, E88.1

  • Subcategory E83.8 expanded

  • 23 New codes

  • New code added to report type 2 diabetes mellitus without complications in remission.

To see a great overview and in-depth breakdown of the new, deleted, and revised ICD-10-CM codes:

https://hiacode.com/blog/new-icd-10-cm-codes

Symptoms and Signs of the Digestive System and Abdomen

  • 16 new “R” codes added for reporting pain and tenderness in pelvic, perineal, subpubic, abdominal, and flank areas

  • R11.16 Cannabis hyperemesis syndrome code added

  • 5 new codes for costovertebral (angle) tenderness with specificity

  • R76.8- and R76.89 revised

Z Codes to Show More Context

  • New codes for social determinants of health (SDoH); Z59.86- revised, three new Z77.3- codes

  • Food allergies: Z91.011- Allergy to milk products revised, three new codes added and Z91.012 Allergy to egg revised, three new codes added

Oncology

  • C50.A- as a new parent code, three new codes for inflammatory breast cancer (IBC)

  • D71.- Functional disorders of polymorphonuclear neutrophils becoming a new parent code, three new codes

  • Z15.06- Genetic susceptibility to malignant neoplasm of digestive system added

Emergency Dept Coding

  • S30.11-, S30.12-, S30.13- as new parent codes

(Continued)

https://www.aapc.com/blog/92808-cms-releases-fy-2026-icd-10-cm-update/#:~:text=People%20who%20have%20adverse%20reactions,with%20tolerance%20to%20baked%20egg.

CY 2026 Medicare Physician Fee Schedule

Key 2026 Takeaways:

  • Qualifying APM Participants (QPs): $33.57

    • CY 2026 qualifying APM conversion factor of $33.57 represents a projected increase of $1.22 (+3.77%) from the current conversion factor of $32.35.

  • Non-QPs: $33.40

    • CY 2026 nonqualifying APM conversion factor of $33.40 represents a projected increase of $1.05 (+3.26%) from the current conversion factor of $32.35

  • “Per statutory requirements, we are also finalizing updates to the geographic practice cost indices (GPCIs) and malpractice RVUs.” - CMS

https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f

To learn more about RVUs and their significance in medical coding, click here