The Current Procedural Terminology (CPT) code set was updated on January 1, 2026. For urologists, staying informed about newly introduced, revised, and deleted codes is essential for accurate service reporting. Beyond just knowing the new or updated codes, it is also critical for urologists and practices to recognize how the valuations of related codes may shift due to the introduction of new codes.

For January 2026, some of the key updates include:

1. Laparoscopic radical prostatectomy (Table 1): This code will now be expanded to a code set of 3 distinct codes.
2. Prostate biopsy services (Tables 2 and 3): The code set now features separate codes based on the approach (transrectal vs transperineal) and guidance used (nonimaging, ultrasound, MRI-fusion, or in-bore).
3. New procedures for reporting irreversible electroporation of the prostate, cystourethroscopy with balloon dilation and drug delivery for benign prostatic hyperplasia, and transurethral robotic-assisted waterjet resection of the prostate.

Additionally, a number of Category III codes for emerging technologies are introduced, including:

• Benign prostatic hyperplasia treatment using high-intensity focused ultrasound.
• Open implantation, replacement, and revision/removal of subcutaneous with subfascial integrated tibial nerve stimulators.
• Cystoscopy with drug injection, followed by low-energy ureteral lithotripsy for ureter stones.
• Urethral autologous cell therapy for female stress incontinence.

A brief overview of the code changes can be found below. For detailed descriptions and further discussion of these code changes, watch the on-demand recording for Part Four of the AUA CodingPlus (2025) educational series held in December 2025. Click here to register and access.

To receive crucial, real-time, urologic coding updates throughout the year, earn CME credit, and participate in Q&A with expert faculty, check out AUA CodingPlus (2026). With a focus on the most current issues and challenges facing urology practices in the realm of coding, billing, and reimbursement, this 4-part educational series empowers practices to thrive amidst the everchanging health care landscape. The next live virtual course will be held on Wednesday, March 25, 2026, from 7:00 to 8:30 pm ET—sign up now.

CPT Code Changes for 2026

Table 1. Updated Laparoscopic Radical Prostatectomy Code Set Starting January 2026

Abbreviations: CPT, Current Procedural Terminology.

Table 2. Prostate Biopsy Services Code Set Starting January 1, 2026

Abbreviations: CPT, Current Procedural Terminology.

Table 3. Correct Current Procedural Terminology Coding for Biopsy Services Procedure Performed

Abbreviations: CPT, Current Procedural Terminology; SV, seminal vesicles; TP, transperineal; TRUS, transrectal ultrasound; TZ, transition zone.

Other new category I CPT codes

CPT code 55877: Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous.

CPT code 52443: Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a non-drug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed.

CPT code 52597: Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed.

Table 4. Updated Relative Value Units for Certain Transurethral Prostate Resection Codes

Abbreviations: CPT, Current Procedural Terminology; RVU, relative value unit.

New category III codes 

• Codes 0988T, 0989T integrated tibial nerve stimulator services.
• Code 0991T low energy ureteral lithotripsy.
• Code 1000T autologous muscle cell therapy administration of muscle progenitor cells.

Final Rule

The Centers for Medicare & Medicaid Services (CMS) final rule for the calendar year 2026 Medicare Physician Fee Schedule went into effect on January 1, 2026. Some of the major changes that affect urology are listed below.

Increase in the conversion factor (CF; Table 4): The CF (which is used to calculate payment for services rendered) increased for the first time in years due to a small statutory adjustment as a result of the Medicare Access and CHIP Reauthorization Act of 2015, a 2.5% boost from the 2025 One Big Beautiful Bill Act, and a 0.55% budget neutrality adjustment addressing changes in relative value units (RVUs). New for 2026 is that there will 2 CFs, 1 for those who are part of a qualified alternative payment model (APM) and 1 for non-APM clinicians. APM participants will see a 0.75% update, whereas non-APM participants will receive a 0.25% update; therefore, in addition to the 2.5% and 0.55% as listed above adjustments, the final CF for APM participants will be $33.59 (an increase of $1.24, or 3.8%) and $33.42 for non-APM participants (an increase of $1.07, or 3.3%).

Reduction in reimbursement due to efficiency adjustment: CMS has finalized a 2.5% reduction in intra-service time payment for non–Evaluation and Management Services and non-time-based procedures. This results in a corresponding reduction in work RVUs (and payment) for procedures, radiology services, and diagnostic tests. CMS feels that there is an unaccounted increase in efficiency of these procedures and services, and therefore felt an adjustment was needed. CMS was also concerned about the data used to determine service values in the first place, which primarily comes from the American Medical Association Relative Value Scale Update Committee surveys. New CPT codes for 2026 were excluded from this adjustment for now. CMS plans on continuing to adjust the intra-service time moving forward as they see fit.

Updates to the practice expense methodology: CMS is reducing the value for indirect expenses (for example, rent, electricity, wages for office staff, billing, scheduling) for procedures performed in a hospital setting. CMS states this was needed as they say they assumed that physicians maintained an office-based practice while also providing care in a facility setting, and argues that with fewer physicians owning their practices they may be overpaying for the indirect costs to a practitioner when a service is performed in the facility/hospital setting. CMS is reducing the portion of the facility practice expense (PE) RVUs allocated based on work RVUs to half the amount allocated to non-facility PE RVUs; indirect PE that is paid to providers will go down in the facility setting and up in the non-facility setting.

WISeR (Wasteful and Inappropriate Service Reduction) model begins: CMS implemented the WISeR model, which is a 6-year model that they say is focused on reducing fraud, waste (including low-value care), and abuse in the Medicare program. This model is taking place in 6 states (New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington) and is basically a prior authorization program for selected services. In urology, services are included that have National Coverage Determinations (NCDs) including Sacral Nerve Stimulation for Urinary Incontinence (NCD 230.18), Incontinence Control Devices (NCD 230.10), and the Diagnosis and Treatment of Impotence (NCD 230.4). It is important that providers in those states follow the WISeR Operational Guide, which can be found here.

Conclusion

For more on the rationale for any changes, descriptions of rules, clinical examples, and exclusive content on radiation oncology changes, sign up for AUA CodingPlus (2025) to watch the on-demand recording for Part Four held in December 2025. To receive crucial, real-time urologic coding updates throughout the year, earn CME credits, and have a chance to ask questions of Dr Rubenstein and the faculty members, check out AUA CodingPlus (2026). With a focus on the most current issues and challenges facing urology practices in the realm of coding, billing, and reimbursement, this 4-part educational series empowers practices to thrive amidst the everchanging health care landscape. The next seminar will be held Wednesday, March 25, 2026, from 7:00 to 8:30 pm ET. Register now for this important event.

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