The 2026 update to the Current Procedural Terminology[i] (CPT)®has 288 new codes, 46 revised codes, and 84 deleted codes. In addition, the ICD-10-CM[ii] update has 553 revisions, additions and deletions. In radiology, the most significant procedure code changes affect interventional radiologists performing lower extremity revascularization and certain biopsies, and diagnostic radiologists will see changes in CT Angiography and CT Cerebral Perfusion exams.
Diagnostic Radiology
CT Angiography
CTA Head and CTA Neck are reported together over 75% of the time and were therefore determined by the CPT Editorial Panel to require bundling. This table shows the Medicare reimbursement for the separate coding as compared with the new bundled code:
|
Code |
Description |
Professional |
Global |
|
70496 |
CT Angiography - Head |
$ 80.16 |
$273.89 |
|
70498 |
CT Angiography - Neck |
80.16 |
273.89 |
|
|
Total for CTA Head/Neck |
$160.32 |
$547.77 |
|
|
|
|
|
|
70471 |
CT Angiography head and neck |
$118.24 |
$376.76 |
|
|
|
-26% |
-31% |
Note: Medicare Fee represents the national level using the 2026 CF of $33.4009 for non-QP radiologists.
The separate codes are still available for use when appropriate for separate exams, and they could be available for billing together to certain insurance payers that allow it. All of the code descriptions are “with contrast, includes non-contrast images when performed, with postprocessing.”
CT Cerebral Perfusion Analysis (CTP)
New CPT Category I codes will be available to replace Category III[iii]Code 0042T, opening up the possibility of better reimbursement. The following codes are available for reporting this procedure.
|
CPT Code |
Description |
RVU Value |
Medicare Fee |
|
70472 Add-on |
CT cerebral perfusion analysis with contrast, with concurrent CT or CTA of same anatomy, with postprocessing (Use in conjunction with 70450, 70460, 70470, 70471, 70496) |
PC-1.09 G-4.68 |
PC-$ 36.41 G-$156.32 |
|
70473 |
CT cerebral perfusion analysis with contrast, without concurrent CT or CTA of same anatomy, with postprocessing |
PC-1.42 G-7.22 |
PC-$ 47.43 G-$241.15 |
Note: PC is the professional component (facility),G is for Global (non-facility) billing.
Interventional Radiology
Lower Extremity Revascularization
Six CPT codes (37220-37235) will be replaced by 46 new codes to describe lower extremity revascularization with more granularity. The new codes recognize the complexity and newer techniques of the procedures performed, as well as the trend toward movement of these procedures to outpatient settings.
The codes are divided into four areas:
- Iliac, which includes the common iliac artery, the external iliac artery, and the internal iliac arteries;
- Femoral/Popliteal, which includes the common femora/profunda femoral and the SFA/popliteal arteries;
- Tibial/Peroneal, which includes the anterior tibial artery, posterior tibial artery, and the peroneal artery, plus the Tibial/Peroneal trunk artery;
- Inframalleolar, which includes the dorsal pedal, medial and lateral plantar arteries, and the pedal arch.
In addition to the procedural codes, related services may also be reported. These include ultrasound guidance for vascular access, diagnostic angiography, catheter placements via separate access, thrombolysis, thrombectomy, embolization, moderate sedation, extensive repair or replacement of the artery, and intravascular lithotripsy (IVL) in the iliac and femoral/popliteal arteries.
This is the new code set for lower extremity revascularization:
|
CPT Code |
Description |
RVU Value |
Medicare Fee |
|
|
Revascularization, endovascular, open or percutaneous, with transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; |
||||
|
|
Iliac vascular territory |
|
|
|
|
37254 |
unilateral; straightforward lesion, initial vessel |
G-62.05 PC-10.05 |
$2,072.53 $335.68 |
|
|
37255 Add on |
unilateral; straightforward lesion, each additional vessel |
G-15.27 PC-4.07 |
$510.03 $135.94 |
|
|
37256 |
Unilateral; complex lesion, initial vessel |
G-72.76 PC-14.73 |
$2,430.25 $492.00 |
|
|
37257 Add on |
Unilateral; complex lesion, each additional vessel |
G-17.35 PC-5.27 |
$579.51 $176.02 |
|
|
37258 |
Unilateral; straightforward lesion, with transluminal stent placement, initial vessel |
G-106.65 PC-12.01 |
$3,562.21 $401.14 |
|
|
37259 Add on |
Unilateral; straightforward lesion, with transluminal stent placement, each additional vessel |
G-36.10 PC-5.43 |
$1,205.77 $181.37 |
|
|
37260 |
Unilateral; complex lesion, with transluminal stent placement, initial vessel |
G-252.50 PC-17.36 |
$8,433.73 $579.84 |
|
|
37261 Add on |
Unilateral; complex lesion, with transluminal stent placement, each additional Vessel |
G-100.64 PC-5.77 |
$3,361.47 $192.72 |
|
|
|
Femoral and Popliteal vascular territory |
|
|
|
|
37263 |
Unilateral; straightforward lesion, initial vessel |
G-162.56 PC-10.66 |
$5,429.65 $356.05 |
|
|
37264 Add on |
Unilateral; straightforward lesion, each additional vessel |
G-65.37 PC-4.08 |
$2,183.42 $136.28 |
|
|
37265 |
Unilateral; complex lesion, initial vessel |
G-204.43 PC-14.42 |
$6,828.15 $481.64 |
|
|
37266 Add on |
Unilateral; complex lesion, each additional vessel |
G-73.08 PC-5.43 |
$2,440.94 $181.37 |
|
|
37267 |
Unilateral; straightforward lesion, with transluminal stent placement, initial vessel |
G-155.94 PC-12.02 |
$5,208.54 $401.48 |
|
|
37268 Add on |
Unilateral; straightforward lesion, with transluminal stent placement, each additional vessel |
G-100.60 PC-5.08 |
$3,360.13 $169.68 |
|
|
37269 |
Unilateral; complex lesion, with transluminal stent placement, initial vessel |
G-345.90 PC-20.20 |
$11,553.37 $674.70 |
|
|
37270 Add on |
Unilateral; complex lesion, with transluminal stent placement, each additional vessel |
G-104.66 PC-6.82 |
$3,495.74 $227.79 |
|
|
37271 |
Unilateral; straightforward lesion, with transluminal atherectomy, initial vessel |
G-316.24 PC-12.32 |
$10,562.70 $411.50 |
|
|
37272 Add on |
Unilateral; straightforward lesion, with transluminal atherectomy, each additional vessel |
G-69.97 PC-5.43 |
$2,337.06 $181.37 |
|
|
37273 |
Unilateral; complex lesion, with transluminal atherectomy, initial vessel |
G-396.05 PC-17.25 |
$13,228.43 $576.17 |
|
|
37274 Add on |
Unilateral; complex lesion, with transluminal atherectomy, each additional vessel |
G-74.45 PC-7.48 |
$2,486.70 $249.84 |
|
|
37275 |
Unilateral; straightforward lesion, with transluminal stent placement and transluminal atherectomy, initial vessel |
G-307.65 PC-15.01 |
$10,275.79 $501.35 |
|
|
37276 Add on |
Unilateral; straightforward lesion, with transluminal stent placement and transluminal atherectomy, each additional vessel |
G-103.55 PC-5.77 |
$3,458.66 $192.72 |
|
|
37277 |
Unilateral; complex lesion, with transluminal stent placement and transluminal atherectomy, initial vessel |
G-461.69 PC-20.41 |
$15,420.86 $681.71 |
|
|
37278 Add on |
Unilateral; complex lesion, with transluminal stent placement and transluminal atherectomy, each additional vessel |
G-115.99 PC-8.11 |
$3,874.17 $270.88 |
|
|
|
Tibial and Peroneal vascular territory |
|
|
|
|
37280 |
Unilateral; straightforward lesion, initial vessel |
G-80.75 PC-13.40 |
$2,697.12 $447.57 |
|
|
37281 Add on |
Unilateral; straightforward lesion, each additional vessel |
G-22.04 PC-4.03 |
$736.16 $134.61 |
|
|
37282 |
Unilateral; complex lesion, initial vessel |
G-182.58 PC-16.81 |
$6,098.34 $561.47 |
|
|
37283 Add on |
Unilateral; complex lesion, each additional vessel |
G-25.84 PC-5.74 |
$863.08 $191.72 |
|
|
37284 |
Unilateral; straightforward lesion, with transluminal stent placement, initial vessel |
G-168.59 PC-13.82 |
$5,631.06 $461.60 |
|
|
37285 Add on |
Unilateral; straightforward lesion, with transluminal stent placement, each additional vessel |
G-83.47 PC-4.56 |
$2,787.97 $152.31 |
|
|
37286 |
Unilateral; complex lesion, with transluminal stent placement, initial vessel |
G-310.35 PC-18.53 |
$10,365.97 $618.92 |
|
|
37287 Add on |
Unilateral; complex lesion, with transluminal stent placement, each additional vessel |
G-147.91 PC-6.86 |
$4,940.33 $229.13 |
|
|
37288 |
Unilateral; straightforward lesion, with transluminal atherectomy, initial vessel |
G-233.40 PC-18.25 |
$7,795.77 $609.57 |
|
|
37289 Add on |
Unilateral; straightforward lesion, with transluminal atherectomy, each additional vessel |
G-27.59 PC-6.43 |
$921.53 $214.77 |
|
|
37290 |
Unilateral; complex lesion, with transluminal atherectomy, initial vessel |
G-318.74 PC-22.96 |
$10,646.20 $766.88 |
|
|
37291 Add on |
Unilateral; complex lesion, with transluminal atherectomy, each additional vessel |
G-32.20 PC-8.77 |
$1,075.51 $292.93 |
|
|
37292 |
Unilateral; straightforward lesion, with transluminal stent placement and transluminal atherectomy, initial vessel |
G-306.33 PC-20.33 |
$10,231.70 $679.04 |
|
|
37293 Add on |
Unilateral; straightforward lesion, with transluminal stent placement and transluminal atherectomy, each additional vessel |
G-105.06 PC-8.94 |
$3,509.10 $298.60 |
|
|
37294 |
Unilateral; complex lesion, with transluminal stent placement and transluminal atherectomy, initial vessel |
G-455.04 PC-24.37 |
$15,198.75 $813.98 |
|
|
37295 Add on |
Unilateral; complex lesion, with transluminal stent placement and transluminal atherectomy, each additional vessel |
G-179.69 PC-11.27 |
$6,001.81 $376.43 |
|
|
|
Inframalleolar vascular territory |
|
|
|
|
37296 |
Unilateral; straightforward lesion, initial vessel |
G-90.81 PC-15.01 |
$3,033.14 $501.35 |
|
|
37297 Add on |
Unilateral; straightforward lesion, each additional vessel |
G-24.80 PC-5.38 |
$828.34 $179.70 |
|
|
37298 |
Unilateral; complex lesion, initial vessel |
G-102.11 PC-18.52 |
$3,410.57 $618.58 |
|
|
37299 Add on |
Unilateral; complex lesion, each additional vessel |
G-26.90 PC-6.70 |
$898.48 $223.79 |
|
|
CPT Code |
Description |
RVU Value |
Medicare Fee |
|
Intravascular lithotripsy(ies) including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery; |
|||
|
37262 Add on |
Iliac vascular territory |
G-102.07 PC-4.07 |
$3,409.23 $135.94 |
|
37279 Add on |
Femoral and popliteal territory |
G-138.80 PC-5.44 |
$4,636.04 $181.70 |
Prostate Biopsy
Prostate biopsy code 55700 has been deleted and replaced with ten new codes that reflect the various methods of guidance available. Now that the new codes include imaging guidance, separate guidance codes are not to be added. Note that the new add-on code 55715 is to not be used with 55707 or 55709.
|
CPT Code |
Description |
RVU Value |
Medicare Fee |
|
Biopsy, prostate, ultrasound guidance, sextant or ultrasound localized |
|||
|
55707 |
Transrectal |
G-10.24 PC-4.08 |
$342.03 $136.28 |
|
55709 |
Transperineal |
G-17.42 PC-4.88 |
$581.84 $163.00 |
|
Biopsy, prostate, first targeted lesion |
|||
|
55708 |
Transrectal, MRI-fusion-guided |
G-12.56 PC-5.08 |
$419.52 $169.68 |
|
55710 |
Transperineal, MRI-fusion-guided |
G-19.53 PC-5.64 |
$652.32 $188.38 |
|
55711 |
Transrectal, MRI-US-fusion-guided, targeted lesion(s) only |
G-11.00 PC-4.06 |
$367.41 $135.61 |
|
55712 |
Transperineal, MRI-US-fusion-guided, targeted lesion(s) only |
G-18.17 PC-4.73 |
$606.89 $157.99 |
|
Biopsy, prostate, in-bore CT or MRI guidance, first targeted lesion |
|||
|
55713 |
With biopsy of additional targeted lesion(s) |
G-22.88 PC-5.56 |
$764.21 $185.71 |
|
55714 |
Targeted lesion(s) only |
G-22.32 PC-5.06 |
$745.51 $169.01 |
|
Biopsy, prostate, each additional targeted lesion |
|||
|
55715 Add on |
MRI-US-fusion or in-bore CT or MRI guidance |
G-2.43 PC-1.41 |
$81.16 $47.10 |
Category III Codes
For 2026 several new Category III codes related to radiology practice will be available, as follows:
|
CPT Code |
Description |
|
Percutaneous tissue displacement, any method, including imaging guidance |
|
|
1022T Add on |
intra-abdominal/pelvic structures. |
|
1023T Add on |
intrathoracic structures |
|
1024T Add on |
soft tissue |
The codes are used in addition to the codes for the primary procedures.
Diagnosis Coding
New ICD-10 coding has been added in Chapter 18, "Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified."
Pain/Tenderness localized to flank: Flank pain was previously reported using an unlisted abdominal pain code but now has its own code set. This is a very common symptom in CT and ultrasound exams.
- R10.A0 - Flank pain, unspecified
- R10.A1 - Flank pain, right side
- R10.A2 - Flank pain, left side
- R10.A3 - Flank pain, bilateral
- R10.8A1 - Right flank tenderness
- R10.8A2 - Left flank tenderness
- R10.8A9 - Flank tenderness, unspecified
Pain pelvis and perineum: The description of pelvic pain was previously only available as 'unspecified', but the code set has been expanded to include laterality.
- R10.20 - Pelvic and perineum pain unspecified side
- R10.21 - Pelvic and perineum pain right side
- R10.22 - Pelvic and perineum pain left side
- R10.23 - Pelvic and perineum pain bilateral
- R10.24 - Suprapubic pain
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[i]Current Procedural Terminology is a copyrighted code set developed and maintained by the American Medical Association, and CPT is registered trademark.
[ii]ICD stands for International Classification of Diseases, the system owned and copyrighted by the World Health Organization that is used to report diagnoses when submitting claims for reimbursement of physician services, among many other purposes. ICD-10 is the 10th edition of this coding system. CM stands for the Clinical Modification of the classification system.
[iii] Category III codes are temporary codes that allow for data collection for emerging technologies, services, procedures, and service paradigms. They are not routinely reimbursed by most payers, including Medicare, when they are initially issued but that can change as they become more accepted and eventually transitioned into a Category I classification with regular reimbursement.
Erin Stephens, CPC, CIRCC is the Sr. Client Manager, Education at Healthcare Administrative Partners.
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