Urology CPT Codes 2026: Complete Guide to Prostate Biopsy, Aquablation, and Prostatectomy Coding Changes

The latest revision in Urology CPT was on January 1, 2026, which received its greatest change in more than ten years. Prostate biopsy was actually the only procedure that brought about the change. One code that comprised all types of biopsies irrespective of their technique of approach or mode of imaging used was used over years. 

That code has been eliminated, and it was substituted by a system in which the reimbursement is directly related to the way the biopsy was carried out. Other prostate procedure codes were introduced, brought up to date or retired along with the biopsy overhaul. This guide takes you through what is being changed, what documentation is needed with the new code and which errors are already appearing in claims. 

Why Urology CPT Coding Changed in 2026

CPT code 55700, like biopsy, prostate; needle or punch, single or multiple, endoscopic or transrectal or transperineal biopsy, any approach, was a longstanding code that included transrectal and transperineal biopsies and endoscopic biopsies with or without the image guidance under a single code. 

With MRI-fusion and in-bore biopsy techniques becoming standard practice in urology, that single code was no longer a true resource or clinical work representation on the different approaches to biopsy. To ensure that transrectal, transperineal, and fusion-guided and in-bore biopsies are reported and valued separately, the AMA CPT Editorial Panel voted to remove 55700 and replace it with a family of approach-specific codes. 

Prostate Biopsy CPT Codes (Effective January 1, 2026)

The new biopsy code set is constructed on three questions, what method (transrectal, transperineal, in-bore) was used, what is the imaging that guided biopsy (none, ultrasound, or MRI-fusion) and whether a particular lesion was targeted. This family of codes includes imaging as a type of guidance, making it the only biggest documentation change that urologists should take into consideration. 

• 55700: Deleted. Should not be used in dates of service on or after January 1, 2026; claims that are registered under this code will be rejected. 
• 55705: Biopsy, prostate; any approach, non-imaging-guided. 
• 55706: Biopsy, prostate, needle, transperineal, stereotactic template-guided saturation sampling, with imaging guidance. 
• 55707: Biopsy, prostate, transrectal, ultrasound-guided (systematic/sextant or ultrasound-localized discrete lesion[s]). 
• 55708: Biopsy, prostate, transrectal, ultrasound-guided (sextant) MRI-fusion guided, first targeted lesion. 
• 55709: Biopsy, prostate, transperineal, ultrasound-guided (systematic/sextant or ultrasound-localized discrete lesion[s]).
• 55710: Biopsy, prostate, transperineal, ultrasound-guided (sextant) with MRI-fusion guidance, first targeted lesion.
• 55711: Biopsy, prostate, transrectal, MRI-ultrasound fusion guided, targeted lesion(s) only, first targeted lesion.
• 55712: Biopsy, prostate, transperineal, MRI-ultrasound fusion guided, targeted lesion(s) only, first targeted lesion.
• 55713: Biopsy, prostate, in-bore CT- or MRI-guided (sextant), with biopsy of additional targeted lesion(s), first targeted lesion.
• 55714: Biopsy, prostate, CT- or MRI-guided, in-bore targeted lesion(s) only, and first targeted lesion.
• +55715: Biopsy, prostate, each add-on MRI-ultrasound fusion or in-bore CT-/MRI-guided targeted lesion (add-on code, listed alongside the code of primary biopsy). 

Documentation Requirements for the New Biopsy Codes

Viable notes should obviously back the code selection under such an arrangement. Documentation should state:

• Method employed: transrectal, transperineal or within the bore CT/MRI.
• Image guidance employed: none, ultrasound only or MRI-ultrasound fusion.
• Systematic (sextant) or focused on target lesion biopsy or both during the same session.
• The total number of separate lesions targeted, as each that is subject to separate reporting is recorded as +55715, whether or not there are multiple cores taken out of it.
• Assurance that when 55710, 55712, or 55715 is billed, a fusion platform was utilized by name, because payers are seeking this information on audit. 

Coding Tips for the 2026 Biopsy Code Set

• Report of targeted lesions: one report per lesion, not per core. Two or more cores of the same lesion will still be attributable to the same unit of a relevant code.
• Do not claim CPT 76872 (transrectal ultrasound) or 76942 (ultrasound needle guidance) and 55705-55715. Guidance is bundled and independent billing will result in a NCCI refusal.
• Cognitive fusion, where the physician correlates prior MRI results mentally with on-time ultrasound without the use of special software to do so should not be billed as a fusion code but instead as ultrasound/systematic biopsy only.
• 55712 cannot be billed together with 55710 during a single session; whether or not the targeted or systematic plus targeted is selected, according to what has been done. 

Common Errors to Avoid For Urology CPT Codes

• Charging the deleted code 55700 automatically on 2026-not-yet-renovated templates or superbills.
• Incorrect choice of a fusion code (55708, 55710, 55711, 55712) not documented with the name of the fusion platform being used.
• The inclusion of transrectal ultrasound housing or transrectal needle guidance codes which are contained within the biopsy code already. 
• Core count reporting of additional lesions rather than lesion count reporting. 

Prostate Ablation and Resection Urology CPT Code Changes

In 2026, three other prostate operations were relocated under physical or generic codes to permanent, procedure-specific Category I codes, which indicate the extent to which the procedures have become mainstream in urology practice. 

• 52597: Transurethral robotic-assisted waterjet resection of prostate (Aquablation), intraoperative planning, ultrasound guidance and postoperative bleeding management, complete. Replaces the previous code, Category III 0421T. 
• 55877: Ablation, irreversible electroporation (IRE/NanoKnife), prostate, 1 or more tumours, including with imaging guidance, percutaneous. New Category I code; imaging guidance is not to be billed separately and is bundled. 
• 52443: Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a non-drug-coated balloon catheter, and therapeutic drug delivery in the prostate with a drug-coated balloon catheter, and transrectal ultrasound and fluoroscopy when done. 
• 52647: As of January 1, 2026, laser coagulation of prostate has ceased to be reportable CPT code. 

Coding hint: Billing will be automatically denied by practices that continue to use 0421T to cover Aquablation or continues to bill 52647 to cover laser coagulation. Template update charges and EHR order sets prior to the next such procedure of either type. 

Laparoscopic Radical Prostatectomy in Urology CPT Codes 2026: Three Codes Instead of One

The single laparoscopic radical prostatectomy code was divided into three codes according to the degree of lymphadenectomy done, hence reimbursement has become communicative whether a lymph node dissection was done or not and the extent of the lymph node dissection done. 

• 55866: Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing; includes robotic assistance when performed.
• 55868: Laparoscopy, surgical prostatectomy, retropubic radical, with limited pelvic lymphadenectomy.
• 55869: Laparoscopy, surgical prostatectomy, retropubic radical, with bilateral pelvic lymphadenectomy.

Coding hint: the operative note should indicate the presence of a lymphadenectomy and in this case, it can be limited or bilateral. Only the default of the code 55866 deals with silence of the lymph node dissection. 

Frequently Used Urology CPT Codes

The 2026 update did not impact these core codes, and they continue to be used daily with urology practices: 

• 52000: Cystourethroscopy, diagnostic (separate procedure).
• 52204: Cystourethroscopy with biopsy(s).
• 52281: Cystourethroscopy with calibration and/or dilation of urethral stricture.
• 52351: Cystourethroscopy with ureteroscopy, diagnostic.
• 52353: Cystourethroscopy with ureteroscopy and treatment of ureteral or renal stone(s) with lithotripsy.
• 50590: Extracorporeal shock wave lithotripsy (ESWL).
• 52601: Transurethral resection of prostate (TURP), complete.
• 52648: Laser vaporization of prostate, including control of postoperative bleeding, complete.
• 51798: Measurement of post-voiding residual urine by ultrasound, non-imaging.
• 55250: Vasectomy, unilateral or bilateral, complete.
• 54150: Circumcision, using clamp or other device with regional dorsal penile or ring block.

Note of bundle: The code CPT 52000 (diagnostic cystoscopy) is part of therapeutic cystourethroscopy codes and is not to be billed independently. Check underlying NCCI edits prior to filing claims. 

HCPCS Update For Urology Coding

J9282: Mitomycin for intravesical solution (Zusduri), permanent J-code effective January 1, 2026, for recurrent low-grade intermediate-risk non-muscle invasive bladder cancer.

CureCloudMD Helps Urology Practices Navigate CPT Coding Changes With Greater Accuracy

CPT updates may directly influence the claim submission, reimbursement, and managing denials in urology. There are new approach specific prostate biopsy codes, new revised prostate procedure codes and changes in reporting radical prostatectomy and the accuracy of documentation and selection of codes has come to be particularly vital. 

CureCloudMD’s urology medical billing and coding services help practices match operative documentation with the appropriate CMS codes, identify bundled services, and update billing practices to align with coding changes. Through the accuracy of the coding and submission of the claims in accordance with the payers the practices can help avoid unnecessary denials and safeguard revenue throughout their urology services. 

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• 98%+ Clean Claim Accuracy
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Why This Matters for Urology Practices

The new changes in CPT in 2026 place a special emphasis on documentation-based coding of prostate biopsies and operations. The type of biopsy procedure, imaging mode, location of the lesions, the presence of the fusion technology, and the degree of the lymphadenectomy can result in the use of this or that code. CureCloudMD considers such documentation needs as part of its medical billing services under all specialties to help ensure better coding, cleaner claims and better reimbursement uniformity.

Specialized medical billing and coding may be used to make sure that CPT changes are included in charge templates, coding processes, claim modifications, and denials prevention mechanisms to address practice management (complex procedures).