Radiology CPT Code Changes New Revised and Deleted Codes 2026

Last Updated on August 31, 2026

Radiology practices have several important CPT coding changes to manage in 2026, including new codes for CT angiography, cerebral perfusion, AI-supported coronary imaging, interventional radiology, prostate biopsy, and lower extremity revascularization.

The American Medical Association reports 418 changes in the 2026 CPT code set, including 288 new codes, 46 revisions, and 84 deletions. New Category I codes became effective January 1, 2026.

For radiology teams, implementation requires more than adding new CPT numbers to a coding system. Charge capture, authorization, documentation, payer edits, and billing workflows must also reflect the new code structure.

Key Radiology CPT Code Changes for 2026

CPT 70471 for Head and Neck CTA

CPT 70471 is a new 2026 code for combined CT angiography of the head and neck with contrast, including associated noncontrast imaging when performed.

Previously, practices could report separate CTA codes for the head and neck when both regions were studied. The new code provides a single reporting pathway for the combined examination. CMS lists CPT 70471 among the codes effective January 1, 2026.

Radiology teams should review order sets, authorization mappings, and charge capture rules to ensure combined head and neck CTA services are routed to the correct code.

CPT 70496 and 70498 remain available when only the head or only the neck is imaged. When both regions are evaluated together, CPT 70471 reports the combined study. 

CPT 70472 and 70473 for CT Cerebral Perfusion

CT cerebral perfusion moved from Category III reporting into Category I coding for 2026.

Former CPT 0042T was replaced by:

• 70472 is an add-on code for cerebral perfusion analysis performed with concurrent CT or CTA of the same anatomy. 
• 70473 for cerebral perfusion analysis when concurrent CT or CTA is not performed

CMS confirms the replacement of 0042T with the new 2026 code structure.

Any chargemaster, EHR rule, or authorization workflow still mapped to 0042T should be updated for dates of service beginning January 1, 2026.

CPT 75577 for Coronary Plaque Assessment

One of the more important imaging technology changes is CPT 75577 for quantitative coronary atherosclerotic plaque assessment derived from software analysis of coronary CTA data.

For 2026, CPT 75577 replaces Category III codes 0623T, 0624T, 0625T, and 0626T. CMS confirms this change effective January 1, 2026.

The shift to Category I reporting reflects broader clinical adoption, but Category I status does not by itself guarantee payer coverage. Practices should confirm medical necessity, authorization, documentation, and individual payer policies before assuming separate reimbursement.

CPT 0992T and 0993T for Perivascular Fat Analysis

AI-supported cardiac risk assessment also receives new Category III coding in 2026. 

• 0992T reports noninvasive cardiac risk assessment using software analysis of perivascular fat without concurrent cardiac CT.
• 0993T is an add-on code for analysis performed with concurrent cardiac CT.

The AMA identifies perivascular fat analysis as one of the AI-supported services added to CPT 2026, while its Category III code file confirms the new 0992T and 0993T codes.

Radiology and cardiovascular imaging teams should distinguish creation of a CPT code from payer coverage. Emerging technology codes can still have payer-specific reimbursement requirements.

CPT 47384 and 55877 for Irreversible Electroporation

The 2026 CPT update introduces Category I codes for irreversible electroporation involving the liver and prostate.

• 47384 reports IRE involving one or more liver tumors.
• 55877 reports IRE involving one or more prostate tumors.
• 0600T remains applicable to IRE involving other organs.

Both 47384 and 55877 include imaging guidance. Separately reporting guidance that is already included in the primary service can create an unbundling issue.

This makes documentation of anatomy, treatment performed, and included imaging services particularly important. New CPT codes can create old billing problems when charge capture and documentation are not updated together.

CPT 37254 Through 37299 for Lower Extremity Revascularization

Lower extremity revascularization has one of the largest CPT restructurings in 2026.

The previous 37220 through 37235 code family was deleted and replaced by 46 new codes from 37254 through 37299. The new structure organizes reporting around vascular territory and adds greater detail around the vessel, procedure, and lesion complexity.

The four territories now include:

• Iliac
• Femoral and popliteal
• Tibial and peroneal
• Inframalleolar

The familiar treatment hierarchy involving angioplasty, stenting, atherectomy, and combined treatment remains relevant, but the 2026 codes further distinguish straightforward stenosis from more complex occlusion treatment.

New add-on codes also include 37262 for intravascular lithotripsy in the iliac territory and 37279 for the femoral and popliteal territory.

CPT 55707 Through 55715 for Prostate Biopsy

Prostate biopsy coding was also substantially restructured.

Nine new CPT codes, 55707 through 55715, were established for 2026. The code structure accounts for biopsy approach and imaging guidance, including transrectal and transperineal procedures and MRI fusion scenarios.

Of particular relevance to imaging:

• 55713 addresses an in-bore CT or MRI-guided sextant biopsy with additional targeted lesion sampling.
• 55714 addresses targeted lesion biopsy using in-bore CT or MRI guidance.

CPT 55705 was revised, while 55700 was deleted. Because imaging guidance is incorporated into parts of the new structure, radiology practices should review whether existing separate guidance charges remain appropriate.

CPT 33882 and Thoracic Endograft Code Changes

Thoracic endovascular aortic repair also changes in 2026.

New CPT 33882 reports deployment of a branched thoracic endograft system involving a fenestration for the subclavian artery.

Existing codes 33880, 33881, 33883, and 33886 were revised, while 33884, 33889, and 33891 were deleted.

These changes make it important to review both code selection and services already incorporated into the primary procedure before reporting additional catheterization or imaging services.

CPT 61624 and 61626 Neurointerventional Coding Changes

CPT 61624 and 61626 were revised for 2026 for neurointerventional embolization procedures.

The revised codes now include radiological supervision and interpretation, intraprocedural roadmapping, and the image guidance required to complete the intervention.

Practices that previously billed related imaging components separately should review their coding rules to prevent duplicate reporting under the revised descriptors.

New Category III Radiology Codes for 2026

Several new Category III codes capture emerging image-guided technologies.

CPT Codes	Service
0981T through 0983T	Hemodynamic IVC device placement and monitoring
0950T	HIFU ablation of benign prostate tissue
0970T	Laser ablation of benign breast tumor
0971T	Laser ablation of malignant breast tumor
0984T and 0985T	OCT imaging of extracranial cerebral vessels
0986T and 0987T	OCT imaging of intracranial cerebral vessels
1022T	Percutaneous tissue displacement for intra-abdominal or pelvic structures
1023T	Percutaneous tissue displacement for intrathoracic structures
1024T	Percutaneous tissue displacement for soft tissue

SIR confirms these new Category III codes as part of the 2026 update. Category III codes require particular attention to payer policy because creation of a CPT code does not establish coverage or reimbursement.

Medicare Payment and Radiology Coding Updates

CPT changes should also be reviewed alongside the 2026 Medicare Physician Fee Schedule.

CMS finalized two 2026 conversion factors:

• $33.5675 for qualifying Advanced APM participants
• #33.4009 for nonqualifying APM participants

ACR estimates the overall 2026 Medicare Physician Fee Schedule impact at approximately negative 2% for radiology, negative 1% for nuclear medicine, positive 2% for interventional radiology, and negative 1% for radiation oncology.

These are specialty-level estimates, not guaranteed changes for individual CPT codes. Practices should review RVUs and payment amounts for their highest-volume procedures.

CMS also continues to update NCCI edits throughout the year. ACR advised radiology practices to review the Q3 2026 edit files effective July 1 and update billing systems where necessary.

How Radiology Practices Can Prepare for 2026

Radiology practices should treat annual CPT implementation as an operational update rather than only a coding update.

Key actions include:

• Remove deleted CPT codes from active chargemasters and billing templates.
• Update EHR order sets for new CTA and cerebral perfusion codes.
• Review authorization mappings for replacement code families.
• Update documentation templates for vascular territory, lesion complexity, imaging guidance, and procedural technique.
• Check whether imaging guidance is bundled into new or revised procedural codes.
• Review payer policies for new Category I and Category III services.
• Update NCCI and MUE edits regularly.
• Monitor early denials involving newly implemented codes.

A practical review should follow the complete path:

Clinical Documentation to CPT Selection to Authorization to Charge Capture to Claim Submission to Payment

Operational example: A coder may correctly select a new 37254 through 37299 code, but the claim can still fail if authorization was obtained under a deleted 37220 through 37235 code. Reviewing only coding accuracy would miss the actual cause of the denial.

For additional guidance on documentation, modifiers, component billing, and bundling, practices can refer to AnnexMed’s radiology coding guidelines.

Keeping Radiology Coding Aligned With 2026 Requirements

The 2026 radiology CPT changes affect several high-value areas, from CTA and cerebral perfusion to coronary imaging, prostate biopsy, neurointerventional procedures, and lower extremity revascularization.

For many organizations, the larger risk is not learning the new CPT numbers. It is making sure documentation, authorization, charge capture, payer rules, and claim edits change with them.

AnnexMed’s radiology billing team supports diagnostic and interventional radiology practices with coding validation, prior authorization, charge review, denial management, and reimbursement follow-up. Connecting these functions can help practices identify coding-related revenue issues before they repeat across a larger volume of claims.

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