Radiology Coding Update: Anticipated CPT Billing Code Changes for 2026

The American College of Radiology (ACR) has released a preview of the anticipated 2026 CPT® code changes, bringing significant updates that will impact multiple radiology-related services. These include new and revised Category I and III codes, as well as code deletions and guideline clarifications. This article outlines the expected modifications and how they may affect billing and clinical reporting for imaging, interventional procedures, and emerging technologies.

New Category I CPT Codes – Effective January 1, 2026

Several new Category I codes have been created to account for bundled services, advances in medical imaging, and evolving procedural standards. These changes aim to enhance coding accuracy, streamline reporting, and ensure fair reimbursement.

Head and Neck CTA (Computed Tomographic Angiography)

A new code will bundle codes 70496 and 70498, which were frequently reported together for head and neck CTA studies.

Computed Tomography Cerebral Perfusion (CTP)

Based on emerging clinical evidence supporting its role in acute stroke management, two new codes will replace the current Category III code 0042T.

Prostate Biopsy

Nine new codes will bundle commonly co-reported services (codes 55700 and 76872). Code 55700 will be deleted, and 55705 will be revised to reflect only non-imaging guided biopsies.

Irreversible Electroporation (IRE)

Two new codes will report percutaneous IRE ablation of liver and prostate tumors with imaging. Code 0600T will be revised accordingly.

Thoracic Branch Endograft Services

Two new codes will be added for thoracic branch endografts, while numerous existing thoracic aorta repair codes will be revised or deleted.

Lower Extremity (LE) Vascular Procedures

Extensive updates include 46 new codes reflecting the reorganization of LE vascular procedures. Codes 37220–37235 will be deleted, and related guidelines updated.

Radiation Oncology Treatment Delivery

Revisions to existing codes and guidelines will clarify “level 1, 2, 3” services. Codes 77014, 77385, and 77386 will be deleted. Terminology such as “simple, intermediate, and complex” will be retired.

New Category III CPT Codes – Effective July 1, 2025

Category III codes are assigned to emerging technologies and procedures. The following new codes will be available mid-2025, supporting evolving treatment modalities in urology, cardiology, and oncology.

Benign Prostate Ablation with HIFU

A new code will be introduced for high-intensity focused ultrasound ablation used in treating benign prostatic hyperplasia (BPH).

Hemodynamic Inferior Vena Cava (IVC) Monitoring

A code will be added to report the implantation of IVC monitoring devices for assessing volume status.

Laser Ablation of Breast Tumor

A new code will cover the laser ablation of benign breast tumors and fibroadenomas, a minimally invasive alternative to surgery.

Revised CPT Codes – Effective January 1, 2026

Several existing codes and accompanying guidelines are being revised to improve accuracy in documentation and billing.

Endovascular Therapy

Codes 61624/75894 and 61624/75898 will be bundled. Codes 61624 and 61626 will be revised to include imaging guidance, and new guidelines will be added to the Endovascular Therapy section.

Sacroiliac (SI) Arthrodesis

Codes 27278 and 27279 and related guidelines will be revised for clarity, with new instructions added for reporting hybrid fusion procedures.

Deleted CPT Codes – Effective January 1, 2026

The following codes will be deleted due to bundling, obsolescence, or replacement by more comprehensive codes:

• 0042T – CT cerebral perfusion
• 33884, 33889, 33891 – Thoracic endograft support procedures
• 37220–37235 – Lower extremity revascularization procedures
• 55700 – Prostate biopsy (to be replaced with new codes)
• 77014, 77385, 77386 – Radiation treatment delivery codes
• 75956–75959 – Imaging for endovascular procedures

Final Thoughts

These changes reflect the ACR’s and AMA’s ongoing commitment to refining CPT coding for radiology and related specialties. Practices should begin preparing now by reviewing the revised descriptors and ensuring billing teams are trained ahead of implementation. For the full list of codes and descriptions, we advise our newsletter subscribers to refer to the upcoming September/October issue.

Struggling with Radiology Coding Accuracy?

Staying ahead of CPT® code changes—like those anticipated for 2026—is essential for radiology practices striving to maintain compliance, optimize reimbursements, and avoid costly denials. But keeping up with evolving codes, complex bundling rules, and payer-specific nuances can quickly overwhelm internal teams, leading to coding inaccuracies, delayed payments, and revenue leakage.

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