CMS publishes FY 2026 ICD-10-PCS code set, guidelines

CMS recently published the fiscal year (FY) 2026 ICD-10-PCS code set and ICD-10-PCS Official Guidelines for Coding and Reporting. Although CMS made no significant changes to the guidelines, only new examples for the new technology guidelines, the ICD-10-PCS code set includes 156 new codes, 27 deleted codes, and four new tables.

This update brings the FY 2025 ICD-10-PCS code set to a total of 78,986 codes available for discharges occurring from October 1, 2025, through September 30, 2026.

The new codes and tables cover a range of procedures, some of which include the following tabular updates in the Medical and Surgical section:

• New body part characters in table 00P for Removal and table 00W for Revision of substitutes in the dura mater or spinal meninges
• New qualifier character in table 031 for Bypass of innominate artery to an upper artery
• New table for Transfer procedures involving the nasal system
• New table for Bypass procedures involving the larynx
• New approach value in table 0F1 for Bypass of the common bile duct to the duodenum
• New qualifier character in table 0RR for Replacement of left and right shoulder joints
• New qualifier characters in table 0SR for Replacement of left and right knee joints

These additions include ICD-10-PCS codes such as:

• 00W20KZ, Revision of nonautologous tissue substitute in dura mater, open approach
• 03120JY, Bypass of innominate artery to upper artery with synthetic substitute, open approach
• 09XL0Z3, Transfer of nasal turbinate to sphenoid bone, open approach
• 0C1S3E4, Bypass of larynx to cutaneous with endotracheal airway, percutaneous approach
• 0F198D3, Bypass of common bile duct to duodenum with intraluminal device, via natural or artificial opening endoscopic
• 0RRJ008 Replacement of right shoulder joint with reverse ball and socket synthetic substitute, subscapularis-sparing technique, open approach
• 0SRD07D, Replacement of left knee joint with autologous tissue substitute, medial meniscus, open approach

Some tables only have one new code, including tables 00H for Insertion into the central nervous system and cranial nerves, 02U for Supplement of heart and great vessels, 04U for Supplement of lower arteries, 64A for Hypothermia of physiological systems, and 8E0 for Other Procedures of physiological systems and anatomical regions.

All 27 deletions occur in new technology tables X2A for Assistance of the cardiovascular system, XW0 for Introduction to anatomical regions, and XXE for Measurement of physiological systems. Ninety new codes fall under 17 new technology tables, of which two are new tables for procedures using new technologies for the Inspection of the gastrointestinal system and Insertion into subcutaneous tissue and fascia. For example:

• XDJ07LB, Inspection of upper intestinal tract using ingestible capsule with light absorption sensor, via natural or artificial opening, new technology group 11
• XHH80HB, Insertion of ultrasound transmitter and battery for endocardiac pacing electrode into chest subcutaneous tissue and fascia, open approach, new technology group 11

To view the FY 2026 code set and guidelines in their entirety, visit the CMS website. Coders can also find the full list of code additions, revisions, and deletions on the CMS website by downloading the order addenda in the 2026 ICD-10-PCS Order File (Long and Abbreviated Titles) (ZIP) file.

Editor's note: This article originally appeared on JustCoding.