The year 2026 brings one of the biggest CPT overhauls in urology in more than a decade. The long-standing prostate biopsy code 55700 is deleted, and a brand-new family of procedure codes replaces it. These new codes bundle imaging, clarify approach, distinguish targeted lesions, and standardize how prostate biopsy is billed across all technologies—including ultrasound, MRI-fusion, and in-bore MRI.
For coders, billers, and physicians, understanding these changes is essential for accurate claims submission, compliance, and revenue protection.
This guide breaks down the new 2026 prostate biopsy codes, explains what is included, and shows how biopsies will be billed starting January 1, 2026.
Why Did the AMA Change the Codes?
Prostate biopsy techniques have advanced significantly. Practices now use:
- Transperineal ultrasound
- Transrectal ultrasound
- MRI–ultrasound fusion
- In-bore MRI targeting
- Template-guided mapping
The old code 55700 did not differentiate any of these methods, which caused:
- Inconsistent billing
- Unbundling of imaging codes
- Wide variation in reimbursement
The 2026 CPT update fixes this by creating technique-specific biopsy codes with bundled imaging guidance.
The New 2026 Prostate Biopsy CPT Codes
Below is a simplified breakdown of the finalized code structure.
Base Biopsy Codes (First Lesion or Standard Sampling)
| CPT Code | 2026 Description (Simplified) |
|---|---|
| 55705 | Prostate biopsy, non–image-guided (revised) |
| 55706 | Transperineal stereotactic template-guided saturation biopsy (includes imaging) |
| 55707 | Transrectal ultrasound-guided biopsy |
| 55708 | Transrectal MRI-fusion-guided biopsy (first targeted lesion) |
| 55709 | Transperineal ultrasound-guided biopsy |
| 55710 | Transperineal MRI-fusion-guided biopsy (first targeted lesion) |
| 55711 | Transrectal MRI-US fusion-guided biopsy (first targeted lesion) |
| 55712 | Transperineal MRI-US fusion-guided biopsy (first targeted lesion) |
| 55713 | In-bore MRI-guided biopsy (first lesion) |
| 55714 | In-bore CT or MRI-guided biopsy of targeted lesions |
Add-On Code for Additional Targeted Lesions
| Code | Description |
|---|---|
| +55715 | Each additional targeted lesion (used with 55708–55714) |
What’s Included in These New Codes?
Imaging guidance is included
These codes replace the need for:
- 76942 – ultrasound needle guidance
- 76872 – diagnostic transrectal ultrasound
- 77012, 77021 – CT/MRI guidance
AMA parentheticals explicitly prohibit billing these together.
✔ Only ONE base code per session
Choose based on:
Whether systematic or targeted
Approach (transrectal vs transperineal)
Imaging method (ultrasound, MRI-fusion, in-bore CT/MRI)
This is the most important change.
If the code says:
- Ultrasound-guided
- MRI-fusion-guided
- MRI-guided
- CT-guided
…then all imaging guidance, targeting, and localization are INCLUDED.
This means the following codes cannot be billed separately:
❌ 76942 – Ultrasound guidance for needle placement
❌ 76872 – Diagnostic transrectal prostate ultrasound (in nearly all cases)
Expect new CCI edits in 2026 that will block these combinations.
Selection is based on:
- Approach: transrectal vs transperineal
- Imaging modality: ultrasound, MRI fusion, in-bore MRI, etc.
- Purpose: systematic sampling vs lesion-targeted
The “first lesion” code is always the base code.
Add +55715 for additional targeted lesions
Remember:
✔ 55700 is deleted
✔ Imaging is bundled into the new biopsy codes
✔ 76942 and 76872 are generally NOT billable
✔ +55715 captures additional targeted lesions
✔ Accurate documentation is essential to support technique used
✔ Only ONE primary biopsy code per encounter
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