February 10, 2026

New Prostate Biopsy CPT Codes Effective January 1, 2026

Prostate Biopsy Approaches

Transperineal: Prostate biopsy performed through the perineum, with needle access obtained externally rather than through the rectum.
Transrectal: Prostate biopsy performed through the rectal wall, with needle access obtained transrectally to sample prostate tissue.

Imaging Guidance Used for Some Prostate Biopsies

Ultrasound: Using real-time imaging to guide biopsy tools to desired location
MRI Ultrasound-fusion: MRI images taken ahead of time are used with real-time ultrasound to see exact location of the target for biopsy
In-Bore CT or MRI guidance: used for needle placement access

Types of Prostate Biopsies

Sextant Biopsy: 6-12 core samples taken from different sections throughout the prostate, not often used anymore as it has a high-risk of missing the cancer.
Template Guided Saturation Sampling: Uses a template to take 20 or more samples of different regions of the prostate at one time. This takes more samples than the standard biopsy. This provides a wider selection of cells to test for cancer. Usually done in high-risk patients or when a clinical suspicion of cancer exists.
Lesion-Based Biopsy: The physician uses imaging to get biopsies of one or more lesions.
Report biopsies once per lesion; typically, multiple biopsies are taken from each lesion.
Use add-on code (55715) for additional lesions where biopsies are taken.

All new codes include imaging. A separate imaging code is not reported.

Practical Coding Application

When applying the new prostate biopsy CPT codes effective 1/1/26, focus on lesion-based reporting rather than the number of cores obtained. Multiple cores taken from the same lesion are reported once per lesion, regardless of how many samples are collected.

Key points to verify in the documentation:

The number of distinct lesions biopsied
Whether biopsies were performed on additional lesions requiring add-on code 55715
The approach used (transperineal or transrectal)
The type of imaging guidance documented, understanding that imaging is bundled into the new codes
If no specific lesion is biopsied, check documentation to see if template saturation biopsy was done

If the operative report does not clearly identify the approach, the technique and the number of lesions targeted (if applies), a query should be considered to support accurate CPT code assignment under the new guidelines.

Katie Brown, CCS

Senior Consultant, Audit at UASI

Katie Brown, CCS, is an AHIMA-certified Senior Coding Consultant specializing in CPT/ICD-10 coding, compliance audits, and revenue cycle support. She’s worked across diverse outpatient and inpatient settings, including ER, surgery, observation, and specialty clinics, and enjoys training coders with practical, CDI-friendly tips.