The American Medical Association (AMA) Current Procedural Terminology (CPT)* code set is updated annually. This article describes CPT 2026 coding changes that are relevant to general surgery and related specialties.
*All specific references to CPT codes and descriptions are © 2025 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
Endoscopic Sleeve Gastroplasty
New code 43889, Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (ESG), including argon plasma coagulation, when performed, was established to report endoscopic sleeve gastroplasty to reduce the volume of a patient's stomach to assist with weight loss. This new code was placed in the Stomach/Other Procedures subsection of the CPT codebook and has a 90-day global period assignment.
Percutaneous Irreversible Electroporation (IRE) of Liver Tumor(s)
Category III code 0600T was deleted and new Category I code 47384, Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous, was established to report ablation of liver tumor(s) using an IRE device. This new code was placed in the Liver/Other Procedures subsection of the CPT codebook and has a 0-day global period assignment.
Deletion of the Term Peritoneoscopy
In 1996, the term peritoneoscopy was deleted from all laparoscopy code descriptors because laparoscopy and peritoneoscopy meant exactly the same thing, and peritoneoscopy was an older, less-used term coined in 1920, based on a modified proctosigmoidoscope. However, the term was not deleted from parentheticals, guidelines, or images. For CPT 2026, all instances of the term peritoneoscopy have been removed from the CPT code set.
Lower Extremity Revascularization
The codes to report lower extremity revascularization (LER) underwent a significant change for 2026. Specifically, codes 37220-37235 were deleted and replaced with 46 new codes that are grouped into four "territories" and type of treatment. The new codes bundle all maneuvers necessary for accessing and selectively catheterizing the artery, crossing the lesion, and performing the endovascular intervention through a percutaneous and/or open surgical exposure, and all imaging for intraprocedural guidance including radiological supervision and interpretation directly related to the intervention performed, and imaging to document completion of the intervention and completion of the procedure. Closure of the arteriotomy by pressure and application of an arterial closure device or standard closure of the puncture by suture is included and not separately reportable. A straightforward lesion is defined as a stenosis and a complex lesion is defined as an occlusion. All codes are designated as unilateral. When a bilateral primary procedure is performed, append modifier 50. However, this modifier should not be appended to add-on codes with a ZZZ global assignment. Instead, the add-on codes should be reported twice. There are additional extensive new guidelines and instructional parentheticals throughout the code set that should be reviewed prior to reporting these codes. Table 1 (below) provides the new codes and global period assigned to each code.
Endovascular Repair of Thoracic Aortic Aneurysms
Endovascular repair of thoracic aortic aneurysms (TEVAR) received FDA approval in March 2005, and CPT codes were established in 2006. In May 2022, the FDA approved the use of a thoracic branch endoprothesis (TBE) during TEVAR procedures. This was the first new type of device to gain FDA approval within the TEVAR family since the codes were established in 2006. The 2026 changes to TEVAR coding includes new, revised, and deleted codes, with the following changes: (1) Catheter placement, radiologic supervision and interpretation, and all proximal extensions performed at the time of TEVAR are now bundled into the main procedure; (2) A new code has been created for the distinct work required for a TBE, which includes all the work of a TEVAR; and (3) there will no longer be separate codes for extra-anatomic bypass surgery performed in conjunction with TEVAR. In addition, there are significant revisions to the coding guidelines that should be reviewed in the CPT codebook. Table 2 (below) provides the 2026 coding changes and global period assigned to each code.
Baroreflex Activation Therapy
New codes have been established for CPT 2026 that describe treatment of resistant hypertension or heart failure using a baroreflex activation therapy (BAT) modulation system comprised of a lead implanted onto the carotid sinus, which is then tunneled and connected to a pulse generator placed in a subcutaneous pocket created in the pectoral region. Interrogation and programming of the BAT system is not separately reportable when performed during the operative session to implant or revise the system. There are additional new guidelines and instructional parentheticals that should be reviewed prior to reporting these codes. Table 3 (below) provides the new codes and global period assigned to each code.
Colon Motility Studies
Codes 91120 and 91122 were identified as being performed by the same physician on the same date of service greater than 75% of the time by the AMA RVS Update Committee. Although it was acknowledged that these procedures are distinct and nonoverlapping, it was also believed the code descriptors did not clearly reflect current services. Therefore codes 91120 and 91122 were deleted and two new codes established for reporting colon motility studies. Table 4 (below) provides the new codes and global period assigned to each code.
Category III Codes
A number of new CPT Category III codes have been established for 2026. Category III codes represent emerging technology, services, procedures, and service paradigms that allow data collection instead of reporting an unlisted code. These codes are contractor priced and may or may not be covered by Medicare and other payers. Table 5 (below) provides Category III code relevant to general surgery and related specialties.
Looking forward to CPT 2027†
The meeting cycle for the CPT 2027 code set has concluded, resulting in new codes and guidelines that will be effective for CPT 2027. Several changes that are important to general surgery and related specialties include:
Diaphragmatic Hernia Repair. Accepted addition of codes 39XX3-39X12 for repair of diaphragmatic hernia; addition of add-on code 39X13 for mesh implantation with diaphragmatic hernia repair; and revision of codes 39540, 39541 to reflect “via laparotomy” for diaphragmatic hernia repair.
Congenital Duodenal Obstruction Repair. Accepted addition of codes 44XX1, 44XX2 to report surgical treatment for congenital duodenal obstruction via an open and a laparoscopic approach; and revision of 44180.
Diaphragm Repair. Accepted addition of code 395X2 to report thoracoscopic plication of diaphragm for eventration or paralysis; and revision of code 39545 to identify open plication of the diaphragm
Endoscopic Submucosal Dissection, Upper and Lower GI. Accepted addition of codes 4XX01, 4XX02 to report endoscopic submucosal dissection (ESD) procedures in the upper or lower GI tract, and addition of guidelines.
Skin Cell Suspension Autograft. Accepted addition of codes 15X19-15X22 for reporting skin cell suspension autograft (SCSA); revision of SCSA guidelines; and deletion of codes 15011-15018.
Maternity Care Services. Accepted addition of codes 59XX1-59X12 for reporting maternity care services with new guidelines for these codes; revision of maternity care guidelines; revision of codes 59412, 59051, 59300, 59898, 59899; and deletion of codes 59050, 59400, 59409, 59410, 59425, 59426, 59430, 59510, 59514, 59415, 59525, 59610, 59612, 59614, 59618, 59620, 59622.
Real-time Fluorescence Wound Imaging. Accepted addition of code 976XX for reporting real-time florescence wound imaging with clinical darkness; and deletion of codes 0598T, 0599T.
Open Irreversible Electroporation of Tumor, Pancreas. Accepted addition of 48XXX for reporting open irreversible electroporation (IRE) ablation of tumors of the pancreas; and revision of Category III code 0601T to describe open IRE ablation of tumors in organs other than the pancreas.
Microvascular Bypass, Lymphatic Vessels. Accepted addition of codes 38X03, 38X04 for microvascular anastomosis services; addition of microvascular lymphovenous bypass surgery guidelines; and deletion of code 1019T.
†Summary of CPT Editorial Panel action documents accessed October 23, 2025, at www.ama-assn.org/about/cpt-editorial-panel/summary-panel-actions.
Learn More
As part of the ACS’s ongoing efforts to help members and their practices submit clean claims and receive proper reimbursement, a coding consultation service—the ACS Coding Hotline—has been established for coding and billing questions. ACS members are offered five free consultation units (CUs) per calendar year. One CU is a period of up to 10 minutes of coding services time. Access the ACS Coding Hotline website at prsnetwork.com/acshotline.
Dr. Megan McNally is a surgical oncologist at Saint Luke’s Health System in Kansas City, Missouri, and assistant clinical professor in the Department of Surgery at the University of Missouri-Kansas City School of Medicine. She also is a member of the ACS General Surgery Coding and Reimbursement Committee and the ACS advisor to the AMA CPT Editorial Panel.
