2026 so far
- Codes added
- 308
- 4 releases
- Codes discontinued
- 117
- 21 with a same-product code
- Long descriptions revised
- 315
- Payment field changes
- 81
- January annual update
- 160 added
- 78 of them M codes
- Latest release
- October 2026
Changes by quarter
The January annual update carries most of the year's work: in 2026 it added 160 codes, more than the 148 added by the other releases combined, and revised 294 long descriptions. The April, July and October releases add new drugs, biologicals and devices as they come to market and retire the temporary codes those products used before.
| Release | Added | Discontinued | Long description | Short description | Payment field | Coverage code | Administrative field | Administrative field and long description | Miscellaneous |
|---|---|---|---|---|---|---|---|---|---|
| January 2026 | 160 | 95 | 294 | 1 | 65 | 0 | 0 | 0 | 0 |
| April 2026 | 62 | 6 | 5 | 0 | 7 | 1 | 0 | 1 | 2 |
| July 2026 | 41 | 1 | 5 | 2 | 4 | 0 | 4 | 0 | 1 |
| October 2026 | 45 | 15 | 11 | 0 | 5 | 0 | 1 | 0 | 0 |
| Total | 308 | 117 | 315 | 3 | 81 | 1 | 5 | 1 | 3 |
Codes added by range
M codes lead the year with 82 additions; J and Q codes together account for 126, most of them drugs, biologicals, biosimilars and skin substitutes.
| Range | What the range covers | January | April | July | October | Year |
|---|---|---|---|---|---|---|
| M codes | Quality measures and other services | 78 | 2 | 2 | 0 | 82 |
| J codes | Drugs administered other than oral method | 21 | 11 | 12 | 23 | 67 |
| Q codes | Temporary codes | 25 | 20 | 9 | 5 | 59 |
| C codes | Outpatient PPS (temporary hospital codes) | 19 | 10 | 3 | 3 | 35 |
| G codes | Procedures and professional services (temporary) | 14 | 5 | 13 | 1 | 33 |
| A codes | Transportation, medical and surgical supplies | 3 | 12 | 1 | 8 | 24 |
| L codes | Orthotic and prosthetic procedures and devices | 0 | 2 | 0 | 3 | 5 |
| E codes | Durable medical equipment | 0 | 0 | 0 | 2 | 2 |
January 2026 annual update
160 additions, 95 discontinued, 294 long descriptions revised, 65 payment-field changes.
82 additions other than M codes, mostly drugs, biologicals and temporary C and G codes.
| HCPCS | Descriptor | OPPS SI / APC |
|---|---|---|
| A4295 | Intermittent urinary catheter; straight tip, hydrophilic coating, each | N |
| A4296 | Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each | N |
| A4297 | Intermittent urinary catheter; hydrophilic coating, with insertion supplies | N |
| C1607 | Neurostimulator, integrated (implantable), rechargeable with all implantable and external components including charging system | H / 2086 |
| C1608 | Prosthesis, total, dual mobility, first carpometacarpal joint (implantable) | H / 2087 |
| C7566 | Arthrodesis, interphalangeal joints, with or without internal fixation, with autografts (includes obtaining grafts) | E1 |
| C7567 | Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed, with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i), with computer-assisted image-guided naviagation | E1 |
| C7568 | Catheter placement in coronary artery(ies) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (initial coronary vessel or graft) during coronary angiography including pharmacologically induced stress | E1 |
| C7569 | Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with endoluminal imaging of initial coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report | E1 |
| C7570 | Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation with intraprocedural coronary fractional flow reserve (ffr) with 3d functional mapping of color-coded ffr values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (list separately in addition to code for primary procedure) | E1 |
| C7571 | Percutaneous transluminal coronary angioplasty, single major coronary artery or branch with percutaneous transluminal coronary lithotripsy | E1 |
| C9176 | Tc-99m from domestically produced non-heu mo-99, [minimum 50 percent], full cost recovery add-on, per study dose | K / 1441 |
| C9307 | Injection, linvoseltamab-gcpt, 1 mg | — |
| C9308 | Injection, carboplatin (avyxa), 1 mg | — |
| C9810 | Water circulating motorized cold therapy device (e.g., iceman) including all system components (e.g. pads, console, disposable parts), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2060 |
| C9811 | Electronic ambulatory infusion pump (e.g. sapphire pump), including all pump components, including disposable components , non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2079 |
| C9812 | Echogenic nerve block needles (e.g. sonoplex, sonoblock, sonotap), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2080 |
| C9813 | Perforated continuous infusion catheter set (e.g. infiltralong), including all components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2081 |
| C9814 | Continuous anesthesia echogenic conduction catheter set (e.g. sonolong), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2082 |
| C9815 | Linear peristaltic pain management infusion pump (e.g. cadd-solis ambulatory infusion pump), and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2083 |
| C9816 | Rotary peristaltic infusion pump (e.g., reusable ambit pump) including all disposable system components, reusable non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2084 |
| C9817 | Electronic cryo-pneumatic compression, pain management system (e.g. game ready grpro 2.1 system), including control unit, anatomically correct wrap(s), and other system component(s), non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023) | H1 / 2085 |
| G0568 | Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outreach to and engagement in treatment of a patient directed by the treating physician or other qualified health care professional, initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan, review by the psychiatric consultant with modifications of the plan if recommended, entering patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatric consultant, and provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies (list separately in addition to the advanced primary care management code) | S / 5822 |
| G0569 | Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking patient follow-up and progress using the registry, with appropriate documentation, participation in weekly caseload consultation with the psychiatric consultant, ongoing collaboration with and coordination of the patient's mental health care with the treating physician or other qualified health care professional and any other treating mental health providers, additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatric consultant, provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies, monitoring of patient outcomes using validated rating scales, and relapse prevention planning with patients as they achieve remission of symptoms and/or other treatment goals and are prepared for discharge from active treatment (list separately in addition to advanced primary care management code) | S / 5822 |
| G0570 | Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes, facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team (list separately in addition to advanced primary care management code) | S / 5821 |
| G0571 | Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service) | N |
| G0660 | Team remote e/m new pt 10mins | A |
| G0661 | Team remote e/m new pt 20mins | A |
| G0662 | Team remote e/m new pt 30 mins | A |
| G0663 | Team remote e/m new pt 45mins | A |
| G0664 | Team remote e/m new pt 60mins | A |
| G0665 | Team remote e/m est. pt 10mins | A |
| G0666 | Team remote e/m est. pt 15mins | A |
| G0667 | Team remote e/m est. pt 25mins | A |
| G0668 | Team remote e/m est. pt 40mins | A |
| G9871 | Behavioral counseling for diabetes prevention, online, 60 minutes | M |
| J0013 | Esketamine, nasal spray, 1 mg | E1 |
| J0162 | Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg | N |
| J0654 | Injection, liothyronine, 1 mcg | K / 0900 |
| J1073 | Testosterone pellet, implant, 75 mg | K / 0904 |
| J1736 | Injection, meloxicam (delova), 1 mg | E2 |
| J1737 | Injection, meloxicam (azurity), 1 mg | G / 0898 |
| J1837 | Injection, posaconazole, 1 mg | K / 0905 |
| J2516 | Injection, pentamidine isethionate, 1 mg | N |
| J2596 | Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit | N |
| J2711 | Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg | N |
| J3291 | Injection, tranexamic acid in sodium chloride, 5 mg | E1 |
| J3376 | Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg | N |
| J3379 | Injection, valproate sodium, 5 mg | N |
| J3387 | Injection, elivaldogene autotemcel, per treatment | K / 0906 |
| J3389 | Topical administration, prademagene zamikeracel, per treatment | K / 0908 |
| J7299 | Intrauterine copper contraceptive (miudella) | E1 |
| J7528 | Mycophenolate mofetil, for suspension, oral, 100 mg | — |
| J9184 | Injection, gemcitabine hydrochloride (avyxa), 200 mg | G / 0909 |
| J9256 | Injection, nipocalimab-aahu, 3 mg | G / 0893 |
| J9282 | Mitomycin, intravesical instillation, 1 mg | G / 0913 |
| J9326 | Injection, telisotuzumab vedotin-tllv, 1 mg | G / 0894 |
| Q4398 | Summit ac, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4399 | Summit fx, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4400 | Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4401 | Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4402 | Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4403 | Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4404 | Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4405 | Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4406 | Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4407 | Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4408 | Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4409 | Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4410 | Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4411 | Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4412 | Choriofix, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4413 | Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4414 | Simplichor, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4415 | Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4416 | Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4417 | Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4420 | Nuform, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4431 | Pma skin substitute product, not otherwise specified (list in addition to primary procedure) | S1 / 6000 |
| Q4432 | 510(k) skin substitute product, not otherwise specified (list in addition to primary procedure) | S1 / 6001 |
| Q4433 | 361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure) | S1 / 6002 |
| Q5160 | Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg | G / 0918 |
78 M codes added 2026-01-01 (quality and reporting codes)
| HCPCS | Descriptor | OPPS SI / APC |
|---|---|---|
| M1426 | Encounters conducted via telehealth | M |
| M1427 | Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons) | M |
| M1428 | Patients who have bilateral absence of eyes any time during the patient's history through the end of the measurement period | M |
| M1429 | Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented | M |
| M1430 | Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year) | M |
| M1431 | Encounters conducted via telehealth | M |
| M1432 | Encounters conducted via telehealth | M |
| M1433 | Patient on oral chemotherapy on or within 30 days before denominator eligible encounter | M |
| M1434 | Patient on oral chemotherapy on or within 30 days after denominator eligible encounter | M |
| M1435 | Patient on oral chemotherapy during the performance period | M |
| M1436 | Encounters conducted via telehealth | M |
| M1437 | Encounters conducted via telehealth | M |
| M1438 | Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes) | M |
| M1439 | Significant ocular conditions that impact the visual outcome of surgery | M |
| M1440 | Encounters conducted via telehealth | M |
| M1441 | Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient | M |
| M1442 | Encounters conducted via telehealth | M |
| M1443 | Encounters conducted via telehealth | M |
| M1444 | Delivery at < 39 weeks of gestation | M |
| M1445 | Postpartum care visit before or at 12 weeks of giving birth | M |
| M1446 | Patients who died any time prior to the end of the measure assessment period | M |
| M1447 | Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period | M |
| M1448 | Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period | M |
| M1449 | Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period | M |
| M1450 | Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period | M |
| M1451 | Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period | M |
| M1452 | Patient ever had a diagnosis of dementia | M |
| M1453 | Patients with a pre-operative visual acuity better than 20/40 | M |
| M1454 | New cied | M |
| M1455 | Replaced or revised cied | M |
| M1456 | Patient had a heart transplant | M |
| M1457 | Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period | M |
| M1458 | Patient died prior to the end of the performance period | M |
| M1459 | Patient was in hospice or receiving palliative care services at any time during the performance period | M |
| M1460 | Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure | M |
| M1461 | Patient diagnosis for chronic hepatitis c | M |
| M1462 | Patients with clinical indications for imaging of the head | M |
| M1463 | Documentation of at least two attempts to follow up with patient within 180 days of treatment | M |
| M1464 | No documentation of at least two attempts to follow up with patient within 180 days of treatment | M |
| M1465 | Patient follow up more than 180 days after treatment | M |
| M1466 | Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure | M |
| M1467 | Patients with an existing diagnosis of lynch syndrome | M |
| M1468 | Patient received recommended doses of hepatitis b vaccination based on age | M |
| M1469 | Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period | M |
| M1470 | Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine) | M |
| M1471 | Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules | M |
| M1472 | Patient did not receive recommended doses of hepatitis b vaccination based on age | M |
| M1473 | Patient situations, at any point during the denominator identification period, where the patient's functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders | M |
| M1474 | Patients with diagnosis of dementia | M |
| M1475 | Patients with diagnosis of huntington's disease | M |
| M1476 | Patients with diagnosis of cognitive impairment or alzheimer's disease | M |
| M1477 | Diagnosis of delirium | M |
| M1478 | Psychoactive substance abuse | M |
| M1479 | Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders | M |
| M1480 | Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders | M |
| M1481 | Patients receiving hospice or palliative care or who died during the measurement period | M |
| M1482 | Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period | M |
| M1483 | Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period | M |
| M1484 | Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis) | M |
| M1485 | Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period | M |
| M1486 | Patients admitted to a skilled nursing facility (snf) during the period of evaluation | M |
| M1487 | Patients in hospice in the year before or during the period of evaluation | M |
| M1488 | Patients with a diagnosis for dementia in the year before or during the period of evaluation | M |
| M1489 | Patient status documented | M |
| M1490 | Patient status not documented | M |
| M1491 | Receiving esrd mcp dialysis services by the provider during the performance period | M |
| M1492 | Patients who did not report a fall | M |
| M1493 | Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy) | M |
| M1494 | Patients that reported a fall since the last visit | M |
| M1495 | Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall | M |
| M1496 | Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls | M |
| M1497 | Documentation of falls not performed due to medical reasons (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy) | M |
| M1498 | Diagnostic radiology mips value pathway | M |
| M1499 | Interventional radiology mips value pathway | M |
| M1500 | Neuropsychology mips value pathway | M |
| M1501 | Pathology mips value pathway | M |
| M1502 | Podiatry mips value pathway | M |
| M1503 | Vascular surgery mips value pathway | M |
95 codes discontinued with the January 2026 release
| Discontinued | Last descriptor | Last date | Code with the same drug or product |
|---|---|---|---|
| C5271 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area | 2025-12-31 | none listed |
| C5272 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure) | 2025-12-31 | none listed |
| C5273 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children | 2025-12-31 | none listed |
| C5274 | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) | 2025-12-31 | none listed |
| C5275 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area | 2025-12-31 | none listed |
| C5276 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure) | 2025-12-31 | none listed |
| C5277 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children | 2025-12-31 | none listed |
| C5278 | Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) | 2025-12-31 | none listed |
| C9089 | Bupivacaine, collagen-matrix implant, 1 mg | 2025-12-31 | none listed |
| C9305 | Injection, nipocalimab-aahu, 3 mg | 2025-12-31 | J9256 (Injection, nipocalimab-aahu, 3 mg) |
| C9306 | Injection, telisotuzumab vedotin-tllv, 1 mg | 2025-12-31 | J9326 (Injection, telisotuzumab vedotin-tllv, 1 mg) |
| C9751 | Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[ies]) and all mediastinal and/or hilar lymph node stations or structures and therapeutic intervention(s) | 2025-12-31 | none listed |
| C9784 | Gastric restrictive procedure, endoscopic sleeve gastroplasty, with esophagogastroduodenoscopy and intraluminal tube insertion, if performed, including all system and tissue anchoring components | 2025-12-31 | none listed |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | 2025-12-31 | none listed |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | 2025-12-31 | none listed |
| G0512 | Rural health clinic or federally qualified health center (rhc/fqhc) only, psychiatric collaborative care model (psychiatric cocm), 60 minutes or more of clinical staff time for psychiatric cocm services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm) and including services furnished by a behavioral health care manager and consultation with a psychiatric consultant, per calendar month | 2025-12-31 | none listed |
| G6001 | Ultrasonic guidance for placement of radiation therapy fields | 2025-12-31 | none listed |
| G6002 | Stereoscopic x-ray guidance for localization of target volume for the delivery of radiation therapy | 2025-12-31 | none listed |
| G6003 | Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev | 2025-12-31 | none listed |
| G6004 | Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev | 2025-12-31 | none listed |
| G6005 | Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev | 2025-12-31 | none listed |
| G6006 | Radiation treatment delivery, single treatment area, single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater | 2025-12-31 | none listed |
| G6007 | Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev | 2025-12-31 | none listed |
| G6008 | Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev | 2025-12-31 | none listed |
| G6009 | Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev | 2025-12-31 | none listed |
| G6010 | Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater | 2025-12-31 | none listed |
| G6011 | Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev | 2025-12-31 | none listed |
| G6012 | Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev | 2025-12-31 | none listed |
| G6013 | Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev | 2025-12-31 | none listed |
| G6014 | Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater | 2025-12-31 | none listed |
| G6015 | Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session | 2025-12-31 | none listed |
| G6016 | Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session | 2025-12-31 | none listed |
| G6017 | Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatment | 2025-12-31 | none listed |
| G9604 | Patient survey results not available | 2025-12-31 | none listed |
| J0172 | Injection, aducanumab-avwa, 2 mg | 2025-12-31 | none listed |
| J0190 | Injection, biperiden lactate, per 5 mg | 2025-12-31 | none listed |
| J0200 | Injection, alatrofloxacin mesylate, 100 mg | 2025-12-31 | none listed |
| J0205 | Injection, alglucerase, per 10 units | 2025-12-31 | none listed |
| J0215 | Injection, alefacept, 0.5 mg | 2025-12-31 | none listed |
| J0288 | Injection, amphotericin b cholesteryl sulfate complex, 10 mg | 2025-12-31 | none listed |
| J0350 | Injection, anistreplase, per 30 units | 2025-12-31 | none listed |
| J0365 | Injection, aprotonin, 10,000 kiu | 2025-12-31 | none listed |
| J0380 | Injection, metaraminol bitartrate, per 10 mg | 2025-12-31 | none listed |
| J0395 | Injection, arbutamine hcl, 1 mg | 2025-12-31 | none listed |
| J0710 | Injection, cephapirin sodium, up to 1 gm | 2025-12-31 | none listed |
| J0715 | Injection, ceftizoxime sodium, per 500 mg | 2025-12-31 | none listed |
| J0795 | Injection, corticorelin ovine triflutate, 1 microgram | 2025-12-31 | none listed |
| J0889 | Daprodustat, oral, 1 mg, (for esrd on dialysis) | 2025-12-31 | none listed |
| J1267 | Injection, doripenem, 10 mg | 2025-12-31 | none listed |
| J1330 | Injection, ergonovine maleate, up to 0.2 mg | 2025-12-31 | none listed |
| J1443 | Injection, ferric pyrophosphate citrate solution (triferic), 0.1 mg of iron | 2025-12-31 | none listed |
| J1444 | Injection, ferric pyrophosphate citrate powder, 0.1 mg of iron | 2025-12-31 | none listed |
| J1445 | Injection, ferric pyrophosphate citrate solution (triferic avnu), 0.1 mg of iron | 2025-12-31 | none listed |
| J1452 | Injection, fomivirsen sodium, intraocular, 1.65 mg | 2025-12-31 | none listed |
| J1457 | Injection, gallium nitrate, 1 mg | 2025-12-31 | none listed |
| J1562 | Injection, immune globulin (vivaglobin), 100 mg | 2025-12-31 | none listed |
| J1620 | Injection, gonadorelin hydrochloride, per 100 mcg | 2025-12-31 | none listed |
| J1655 | Injection, tinzaparin sodium, 1000 iu | 2025-12-31 | none listed |
| J1710 | Injection, hydrocortisone sodium phosphate, up to 50 mg | 2025-12-31 | none listed |
| J1945 | Injection, lepirudin, 50 mg | 2025-12-31 | none listed |
| J2504 | Injection, pegademase bovine, 25 iu | 2025-12-31 | none listed |
| J2513 | Injection, pentastarch, 10% solution, 100 ml | 2025-12-31 | none listed |
| J2910 | Injection, aurothioglucose, up to 50 mg | 2025-12-31 | none listed |
| J2940 | Injection, somatrem, 1 mg | 2025-12-31 | none listed |
| J2995 | Injection, streptokinase, per 250,000 iu | 2025-12-31 | none listed |
| J3280 | Injection, thiethylperazine maleate, up to 10 mg | 2025-12-31 | none listed |
| J3305 | Injection, trimetrexate glucuronate, per 25 mg | 2025-12-31 | none listed |
| J3310 | Injection, perphenazine, up to 5 mg | 2025-12-31 | none listed |
| J3320 | Injection, spectinomycin dihydrochloride, up to 2 gm | 2025-12-31 | none listed |
| J3355 | Injection, urofollitropin, 75 iu | 2025-12-31 | none listed |
| J3364 | Injection, urokinase, 5000 iu vial | 2025-12-31 | none listed |
| J3365 | Injection, iv, urokinase, 250,000 i.u. vial | 2025-12-31 | none listed |
| J3400 | Injection, triflupromazine hcl, up to 20 mg | 2025-12-31 | none listed |
| J7309 | Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram | 2025-12-31 | none listed |
| J7310 | Ganciclovir, 4.5 mg, long-acting implant | 2025-12-31 | none listed |
| J7505 | Muromonab-cd3, parenteral, 5 mg | 2025-12-31 | none listed |
| J7513 | Daclizumab, parenteral, 25 mg | 2025-12-31 | none listed |
| J8562 | Fludarabine phosphate, oral, 10 mg | 2025-12-31 | none listed |
| J8650 | Nabilone, oral, 1 mg | 2025-12-31 | none listed |
| J9019 | Injection, asparaginase (erwinaze), 1,000 iu | 2025-12-31 | none listed |
| J9020 | Injection, asparaginase, not otherwise specified, 10,000 units | 2025-12-31 | none listed |
| J9098 | Injection, cytarabine liposome, 10 mg | 2025-12-31 | none listed |
| J9151 | Injection, daunorubicin citrate, liposomal formulation, 10 mg | 2025-12-31 | none listed |
| J9165 | Injection, diethylstilbestrol diphosphate, 250 mg | 2025-12-31 | none listed |
| J9212 | Injection, interferon alfacon-1, recombinant, 1 microgram | 2025-12-31 | none listed |
| J9270 | Injection, plicamycin, 2.5 mg | 2025-12-31 | none listed |
| Q0174 | Thiethylperazine maleate, 10 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | 2025-12-31 | none listed |
| Q2017 | Injection, teniposide, 50 mg | 2025-12-31 | none listed |
| Q4100 | Skin substitute, not otherwise specified | 2025-12-31 | none listed |
| Q4106 | Dermagraft, per square centimeter | 2025-12-31 | none listed |
| Q5109 | Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg | 2025-12-31 | none listed |
| Q9969 | Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose | 2025-12-31 | none listed |
| S0013 | Esketamine, nasal spray, 1 mg | 2025-12-31 | J0013 (Esketamine, nasal spray, 1 mg) |
| S0080 | Injection, pentamidine isethionate, 300 mg | 2025-12-31 | J2516 (Injection, pentamidine isethionate, 1 mg) |
| S0189 | Testosterone pellet, 75 mg | 2025-12-31 | J1073 (Testosterone pellet, implant, 75 mg) |
April 2026 update
62 additions, 6 discontinued, 5 long descriptions revised, 7 payment-field changes.
| HCPCS | Descriptor | OPPS SI / APC |
|---|---|---|
| A2040 | Microlyte painguard, per square centimeter | S1 / 6001 |
| A2041 | Foundation drs+ duo, per square centimeter | S1 / 6001 |
| A2042 | Foundation drs+ solo, per square centimeter | S1 / 6001 |
| A2043 | Biobrane, per square centimeter | S1 / 6001 |
| A2044 | Biobrane glove, each | N |
| A2045 | Novashield or novogen wound matrix, per square centimeter | S1 / 6001 |
| A4318 | Female external urinary collection cup, with or without ring attachment, per day | Y |
| A4479 | Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type | Y |
| A6548 | Accessory to custom gradient compression garment, silicone band, any size | A |
| A8005 | Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted | E1 |
| A8006 | Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only | E1 |
| A9294 | Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment | E1 |
| C1743 | Scaffold, endovascular non-coronary, resorbable drug eluting, with delivery system (implantable) | H / 2088 |
| C8007 | Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array | J1 / 5465 |
| C8008 | Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator | J1 / 5463 |
| C8009 | Removal of hypoglossal nerve neurostimulator array and pulse generator | Q2 / 5432 |
| C8010 | Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral | — |
| C8011 | Open implantation of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver, including external power source and all system components | J1 / 5465 |
| C8012 | Revision or replacement of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver | J1 / 5463 |
| C8013 | Removal of hypoglossal nerve(s) neurostimulator electrode array(s) and receiver | Q2 / 5432 |
| C9309 | Injection, onasemnogene abeparvovec-brve, per treatment | — |
| C9818 | Suzetrigine, oral, 1 mg | K1 / 0933 |
| G0680 | Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report | S / 1492 |
| G0681 | Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area | N |
| G0682 | Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure) | N |
| G0683 | Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children | N |
| G0684 | Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure) | N |
| J0463 | Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg | N |
| J1098 | Articaine ophthalmic, 8% solution, 0.4 ml | N |
| J1164 | Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg | N |
| J1553 | Injection, immune globulin (yimmugo), 100 mg | K / 0923 |
| J3404 | Injection, zopapogene imadenovec-drba suspension, per therapeutic dose | G / 0924 |
| J8502 | Injection, aprepitant (aponvie), 1 mg | N |
| J9003 | Leuprolide injectable (camcevi etm), 1 mg | E2 |
| J9183 | Gemcitabine intravesical system, 225 mg | G / 0926 |
| J9277 | Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph | G / 0930 |
| J9278 | Injection, carboplatin (avyxa), 1 mg | G / 0917 |
| J9601 | Injection, linvoseltamab-gcpt, 1 mg | G / 0916 |
| L2221 | Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source | A |
| L5992 | All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only | A |
| M0233 | Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose | S / 1506 |
| M0234 | Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose | S / 1506 |
| Q0238 | Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg | L |
| Q4418 | Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4419 | Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4421 | Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4422 | A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4423 | Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4424 | Revive ft, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4425 | Revive tl, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4426 | Dermabind tl + or dermabind tl x, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4427 | Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4428 | Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4429 | Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4435 | Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4436 | Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4437 | Revival ac, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4438 | Pretect, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4439 | Instagraft, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4440 | Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q5161 | Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg | G / 0951 |
| Q5162 | Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg | G / 0934 |
6 codes discontinued with the April 2026 release
| Discontinued | Last descriptor | Last date | Code with the same drug or product |
|---|---|---|---|
| C9145 | Injection, aprepitant, (aponvie), 1 mg | 2026-03-31 | none listed |
| C9307 | Injection, linvoseltamab-gcpt, 1 mg | 2026-03-31 | J9601 (Injection, linvoseltamab-gcpt, 1 mg) |
| C9308 | Injection, carboplatin (avyxa), 1 mg | 2026-03-31 | J9278 (Injection, carboplatin (avyxa), 1 mg) |
| L6000 | Partial hand, thumb remaining | 2026-03-31 | none listed |
| L6010 | Partial hand, little and/or ring finger remaining | 2026-03-31 | none listed |
| L6020 | Partial hand, no finger remaining | 2026-03-31 | none listed |
July 2026 update
41 additions, 1 discontinued, 5 long descriptions revised, 4 payment-field changes. 1 new Level II modifier (AC).
| HCPCS | Descriptor | OPPS SI / APC |
|---|---|---|
| A9574 | Injection, ferumoxytol, 1 mg | G / 0935 |
| AC (modifier) | Initial onboarding support payment for access beneficiary enrollment, device/app setup, and care coordination activities; first month only; once per beneficiary per track | — |
| C1609 | Vertebral device, motion-preserving, with screw fixation | H / 2089 |
| C8014 | Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, including use of a suction enabled ureteral access sheath, with irrigation (if performed) | J1 / 5375 |
| C9310 | Injection, leucovorin calcium (avyxa), 1 mg | — |
| G0574 | Management of new patient with dementia residing in an eligible residential care community, for use only in a medicare-approved cmmi model (services must be furnished within a patient's eligible residential care community, including assisted living facilities, board and care homes, or other qualifying residential settings where dementia care services are provided) | M |
| G0575 | Management of established patient with dementia residing in an eligible residential care community, for use only in a medicare-approved cmmi model (services must be furnished within a patient's eligible residential care community, including assisted living facilities, board and care homes, or other qualifying residential settings where dementia care services are provided) | M |
| G0577 | Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction performed in the non-facility setting | B |
| G0669 | Outcome-aligned payment (oap) for technology-enabled chronic care management of early cardio-kidney-metabolic (eckm) conditions (hypertension, or two or more of: dyslipidemia, obesity/overweight with central obesity marker, prediabetes); initial 12-month period; per month | M |
| G0670 | Outcome-aligned payment (oap) for technology-enabled chronic care management of early cardio-kidney-metabolic (eckm) conditions (hypertension, or two or more of: dyslipidemia, obesity/overweight with central obesity marker, prediabetes); follow-on 12-month period; per month | M |
| G0671 | Outcome-aligned payment (oap) for technology-enabled chronic care management of cardio-kidney-metabolic (ckm) conditions (one or more of: diabetes mellitus, chronic kidney disease stage 3a or 3b, atherosclerotic cardiovascular disease); initial 12-month period; per month | M |
| G0672 | Outcome-aligned payment (oap) for technology-enabled chronic care management of cardio-kidney-metabolic (ckm) conditions (one or more of: diabetes mellitus, chronic kidney disease stage 3a or 3b, atherosclerotic cardiovascular disease); follow-on 12-month period; per month | M |
| G0673 | Outcome-aligned payment (oap) for technology-enabled chronic care management of musculoskeletal (msk) conditions (chronic musculoskeletal pain); initial 12-month treatment period; per month | M |
| G0674 | Outcome-aligned payment (oap) for technology-enabled chronic care management of behavioral health (bh) conditions (one or more of: depression, anxiety); initial 12-month period; per month | M |
| G0675 | Outcome-aligned payment (oap) for technology-enabled chronic care management of behavioral health (bh) conditions (one or more of: depression, anxiety); follow-on 12-month period; per month | M |
| G0676 | Standard co-management service payment for documented review of clinical updates from access participant managing cardio-kidney-metabolic conditions (early cardio-kidney-metabolic [eckm] or cardio-kidney-metabolic [ckm] track); per review | M |
| G0677 | Standard co-management service payment for documented review of clinical updates from access participant managing musculoskeletal (msk) conditions; per review | M |
| G0678 | Standard co-management service payment for documented review of clinical updates from access participant managing behavioral health (bh) conditions (depression, anxiety); per review | M |
| J0528 | Injection, fosfomycin disodium, 20 mg | K / 0937 |
| J1289 | Injection, narsoplimab-wuug, 1 mg | G / 0938 |
| J1577 | Injection, immune globulin (qivigy), 100 mg | K / 0939 |
| J2361 | Injection, depemokimab-ulaa, 1 mg | G / 0940 |
| J2374 | Apraclonidine hydrochloride ophthalmic, 1% solution, 0.1 ml | N |
| J2789 | Riboflavin 5'-phosphate, ophthalmic solution (epioxahd/epioxa), up to 2 ml | G / 0941 |
| J3386 | Injection, etuvetidigene autotemcel, per treatment | E2 |
| J3405 | Injection, onasemnogene abeparvovec-brve, per treatment | G / 0922 |
| J7176 | Injection, human fibrinogen - chmt (fesilty), 1 mg | E2 |
| J9053 | Injection, belantamab mafodotin-blmf, 0.1 mg | K / 0957 |
| J9062 | Injection, amivantamab 5 mg and hyaluronidase-lpuj | G / 0942 |
| J9232 | Injection, docetaxel (hospira), not therapeutically equivalent to j9171, 1 mg | K / 0977 |
| M0231 | Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, first dose | S / 1506 |
| M0232 | Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, second dose | S / 1506 |
| Q0234 | Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, 1 mg | L |
| Q5164 | Injection, ustekinumab-hmny (starjemza), biosimilar, 1 mg | E2 |
| Q5165 | Injection, denosumab-mobz (oziltus), biosimilar, 1 mg | E2 |
| Q5166 | Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mg | K / 0974 |
| Q5167 | Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg | K / 0949 |
| Q5168 | Injection, ranibizumab-leyk (nufymco), biosimilar, 0.1 mg | K / 0975 |
| Q5169 | Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg | K / 0976 |
| Q5170 | Injection, aflibercept-boav (eydenzelt), biosimilar, 1 mg | E2 |
| Q5171 | Injection, denosumab-mobz (boncresa), biosimilar, 1 mg | E2 |
1 code discontinued with the July 2026 release
| Discontinued | Last descriptor | Last date | Code with the same drug or product |
|---|---|---|---|
| C9309 | Injection, onasemnogene abeparvovec-brve, per treatment | 2026-06-30 | J3405 (Injection, onasemnogene abeparvovec-brve, per treatment) |
October 2026 update
45 additions, 15 discontinued, 11 long descriptions revised, 5 payment-field changes. The October 2026 update report covers this release in more detail.
| HCPCS | Descriptor | OPPS SI / APC |
|---|---|---|
| A2046 | Dermisphere hdrt, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6001 |
| A2047 | Lacertamatrix, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6001 |
| A2048 | Puraply mz, per milligram | N |
| A2049 | Theracor, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6001 |
| A2050 | Fibrillar collagen wound dressing, per milligram | N |
| A4228 | Supplies for maintenance of non-insulin, device-drug combination infusion catheter, per week | N |
| A6614 | Supplies and accessories for use with an external ocular negative pressure pump, any type, per month | N |
| A9613 | Piflufolastat f 18 (pylarify truvu), diagnostic, 1 millicurie | G / 0962 |
| C9311 | Injection, eplontersen, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) | G / 0958 |
| C9312 | Injection, trabectedin (apotex), not therapeutically equivalent to j9362, 0.01 mg | G / 0959 |
| C9313 | Injection, pivekimab sunirine-pvzy, 0.01 mg | G / 0960 |
| E0788 | Ambulatory infusion pump, specific device-drug combination, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient | Y |
| E2403 | External ocular negative pressure pump, electric | Y |
| G0685 | Algorithm-based assessment of likelihood of autism spectrum disorder (asd), derived from validated analysis of eye-gaze data or other technology | S / 5734 |
| J0014 | Cocaine hydrochloride nasal solution (goprelto), 1 mg | N |
| J0643 | Injection, leucovorin calcium, not otherwise specified, 1 mg | N |
| J0644 | Injection, leucovorin calcium (avyxa), 1 mg | G / 0936 |
| J0871 | Injection, daptomycin (endo), not therapeutically equivalent to j0878, 1 mg | K / 0966 |
| J1757 | Injection, tividenofusp alfa-eknm, 1 mg | K / 0967 |
| J1818 | Injection, pegzilarginase-nbln, 0.05 mg | K / 0968 |
| J1946 | Injection, furosemide (lasix onyu), 1 mg | E1 |
| J1947 | Injection, furosemide (furoscix), 1 mg | E1 |
| J1957 | Injection, levetiracetam, 5 mg | N |
| J1958 | Injection, levetiracetam in sodium chloride, 5 mg | N |
| J3268 | Injection, delafloxacin, 1 mg | E2 |
| J3406 | Injection, omidubicel-onlv, per therapeutic dose | K / 0969 |
| J7524 | Mycophenolate mofetil, oral, 5 mg | N |
| J7526 | Injection, mycophenolate mofetil, 5 mg | N |
| J7529 | Mycophenolate mofetil, for suspension, oral, 5 mg | N |
| J7530 | Mycophenolate mofetil (myhibbin), oral suspension, 5 mg | N |
| J7531 | Prednisolone sodium phosphate, orally disintegrating tablet, 1 mg | E1 |
| J9066 | Injection, bendamustine hydrochloride (avyxa), 1 mg | E2 |
| J9186 | Injection, etoposide (avyxa), 1 mg | G / 0970 |
| J9187 | Injection, etoposide, 1 mg | N |
| J9191 | Injection, fluorouracil (avyxa), 10 mg | G / 0971 |
| J9192 | Injection, fluorouracil, 10 mg | N |
| J9362 | Injection, trabectedin, 0.01 mg | K / 0972 |
| L1330 | Thoracic orthosis, sternal and/or sternocostal compression, may include anterior and/or posterior pads, panels, with or without frame, prefabricated, off the shelf | A |
| L1972 | Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf | A |
| L8697 | External accessory for use with implantable phrenic nerve stimulation device, replacement, each | A |
| Q4207 | Carbon life, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4223 | Dermabind sl optic, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q4243 | Amchomatrix, per square centimeter (add-on, list separately in addition to primary procedure) | S1 / 6002 |
| Q5172 | Injection, filgrastim-laha (filkri), biosimilar, 1 microgram | K / 0973 |
| Q5173 | Injection, denosumab-adet (ponlimsi), biosimilar, 1 mg | E2 |
15 codes discontinued with the October 2026 release
| Discontinued | Last descriptor | Last date | Code with the same drug or product |
|---|---|---|---|
| C8010 | Percutaneous placement of permanent common carotid embolic protection device, including all system components and imaging guidance; bilateral | 2026-09-30 | none listed |
| C9046 | Cocaine hydrochloride nasal solution (goprelto), 1 mg | 2026-09-30 | J0014 (Cocaine hydrochloride nasal solution (goprelto), 1 mg) |
| C9310 | Injection, leucovorin calcium (avyxa), 1 mg | 2026-09-30 | J0644 (Injection, leucovorin calcium (avyxa), 1 mg) |
| C9462 | Injection, delafloxacin, 1 mg | 2026-09-30 | J3268 (Injection, delafloxacin, 1 mg) |
| J0640 | Injection, leucovorin calcium, per 50 mg | 2026-09-30 | J0643 (Injection, leucovorin calcium, not otherwise specified, 1 mg) |
| J1941 | Injection, furosemide (furoscix), 20 mg | 2026-09-30 | J1947 (Injection, furosemide (furoscix), 1 mg) |
| J1953 | Injection, levetiracetam, 10 mg | 2026-09-30 | J1957 (Injection, levetiracetam, 5 mg) |
| J7514 | Mycophenolate mofetil (myhibbin), oral suspension, 100 mg | 2026-09-30 | J7530 (Mycophenolate mofetil (myhibbin), oral suspension, 5 mg) |
| J7517 | Mycophenolate mofetil, oral, 250 mg | 2026-09-30 | J7524 (Mycophenolate mofetil, oral, 5 mg) |
| J7519 | Injection, mycophenolate mofetil, 10 mg | 2026-09-30 | J7526 (Injection, mycophenolate mofetil, 5 mg) |
| J7528 | Mycophenolate mofetil, for suspension, oral, 100 mg | 2026-09-30 | J7529 (Mycophenolate mofetil, for suspension, oral, 5 mg) |
| J9181 | Injection, etoposide, 10 mg | 2026-09-30 | J9187 (Injection, etoposide, 1 mg) |
| J9190 | Injection, fluorouracil, 500 mg | 2026-09-30 | J9192 (Injection, fluorouracil, 10 mg) |
| J9352 | Injection, trabectedin, 0.1 mg | 2026-09-30 | J9362 (Injection, trabectedin, 0.01 mg) |
| L8696 | Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each | 2026-09-30 | none listed |
Keeping code files current
A code that is valid on one date of service can be invalid a quarter later, so claim scrubbers and charge masters need every quarterly file, not only the January one. Drug codes change billing units when CMS replaces a code, which moves the units on the claim and the unit limit that applies; check replacements in the MUE lookup and look up any drug in the drug-name index of J codes.
The reference pages for ASP-priced codes are on the HCPCS drug code hub, and the quarter's price changes are in the ASP movers report.
Method
Each quarter's actions come from the CMS HCPCS transaction report (code and action columns only); Discontinue and Discontinued are merged, codes are trimmed, and a code listed twice under the same action counts once. Descriptors, cross-references and last dates come from the alpha-numeric file of the same release. Replacement codes are matched by descriptor (the same drug or product, at the same or a different billing unit) among the codes added during the year. Dental codes are left out because the American Dental Association licenses them. See the reference methodology.
Part of the HCPCS annual roll-up series, rebuilt from each CMS release. Next edition: 2027 edition starting with the January 2027 annual update. Earlier and later editions are listed on the research index.
Download the full table
The CSV holds every HCPCS Level II code added, discontinued or revised in the 2026 quarterly releases: 834 rows, one header row and the columns quarter, hcpcs, record, action, descriptor, termination date, cross reference, same name added, in october asp file, opps si, opps apc, mue practitioner. Its first line is a comment that names each CMS source file with its SHA-256, the data date and the attribution line to keep when you reuse the table.
Table SHA-256 (the rows after the comment line): 006019f8f230e5bf473a11b9f46757d6198560e2bb49a6992c45f40c2dab2e97. Data as of 2026-10-01.
Where QuickIntell fits as codes change
Quarterly code changes reach the claim through coding and charge capture. QuickCode supports qualified coder review of codes, units and NDCs before the claim leaves, and QuickRCM carries claim readiness and denial work with human review.
Frequently asked questions
How many HCPCS codes were added in 2026?
308 HCPCS Level II codes across 4 quarterly releases so far: 160 in January 2026, 62 in April 2026, 41 in July 2026, 45 in October 2026. The January annual update included 78 M codes, which are quality and reporting codes.
How many HCPCS codes were discontinued in 2026?
117 codes, 95 in January 2026, 6 in April 2026, 1 in July 2026, 15 in October 2026. 21 of them have a code added in 2026 whose descriptor names the same drug or product; the HCPCS file lists no cross-reference code for them.
Which code ranges grew the most?
M codes (quality measures and other services) gained 82; J codes (drugs administered other than oral method) gained 67; Q codes (temporary codes) gained 59; C codes (outpatient pps (temporary hospital codes)) gained 35.
How often does CMS update HCPCS Level II?
Quarterly, effective January 1, April 1, July 1 and October 1. This roll-up is refreshed after each release; the October 2026 release is the latest one included, and the 2027 roll-up starts with the January 1, 2027 annual update.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II transaction report, January 2026 quarterly updateVersion January 2026 · effective 2026-01-01 · file HCPC2026_JAN_ANWEB_Transaction Report_12292025.xlsxSHA-256 316876d318cd944c…
- HCPCS Level II alpha-numeric file, January 2026Version January 2026 · effective 2026-01-01 · file HCPC2026_JAN_ANWEB_01122026.txtSHA-256 1a9ce53ae6546c54…
- HCPCS Level II transaction report, April 2026 quarterly updateVersion April 2026 · effective 2026-04-01 · file HCPC2026_APR_ANWEB_Transaction Report.xlsxSHA-256 20cbe5016f107ecb…
- HCPCS Level II alpha-numeric file, April 2026Version April 2026 · effective 2026-04-01 · file HCPC2026_APR_ANWEB.txtSHA-256 7919ccde99515398…
- HCPCS Level II transaction report, July 2026 quarterly updateVersion July 2026 · effective 2026-07-01 · file HCPC2026_JUL_ANWEB_Transaction Report_06172026.xlsxSHA-256 ceac280097d1533d…
- HCPCS Level II alpha-numeric file, July 2026Version July 2026 · effective 2026-07-01 · file HCPC2026_JUL_ANWEB_06172026.txtSHA-256 38e9b478568bb267…
- HCPCS Level II transaction report, October 2026 quarterly updateVersion October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_Transaction Report_09262026.xlsxSHA-256 d47b5a7bc0951a4b…
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- Medicare Part B Drug Payment Limit File, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csvSHA-256 508fba376a29e099…
Disclaimer
HCPCS Level II descriptors are public domain and shown as published. Replacement codes are matched by descriptor and are not CMS crosswalk entries. Operational reference, not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.