FY 2026 ICD-10-PCS Code Set Updates: What Medical Coders Need to Know

Medical coders, it’s that time again! The FY 2026 ICD-10-PCS code updates/changes is here, and there’s a lot to unpack. With 156 new codes, 1 revision, and 27 deletions, this year’s changes are packed with new technologies, surgical techniques, and coding considerations you’ll want to get ahead of.

Here’s your quick and coder-friendly breakdown of the most important updates you need to know.

New Technology: 90 Cutting-Edge Additions – 2026 ICD-10-PCS updates/changes

A whopping 90 of the new codes are in the New Technology section. Two new tables have been introduced to support these innovations:

📍 Table XDJ – Gastrointestinal System, Inspection

New Code: XDJ07LB
Captures use of the PillSense System, a swallowable capsule that uses light absorption to detect GI bleeding. Think of it as a high-tech scout for hidden blood in the GI tract.

Table XHH – Skin, Subcutaneous Tissue & Fascia, Insert

New Code: XHH80HB
Captures the WiSE CRT System — a leadless left ventricular pacemaker implant placed in the chest wall. It’s a game-changer for patients with specific types of heart failure.

What’s Out?
The 27 deleted codes are also from this section. Many have either completed their NTAP (New Technology Add-On Payment) period or are now represented by standard codes elsewhere.

Medical/Surgical Section: 54 New Codes & 2 New Tables

Here are the standout additions in the traditional Medical/Surgical section:

Cricothyroidotomy Captured Separately- ICD-10-PCS 2026 Code Updates/changes

New Table: 0C1 – Mouth and Throat, Bypass
CMS now recognizes this procedure as distinct from tracheostomy, despite early opposition. Keep this in mind when coding emergency airway interventions.

Skull Base Repairs with Nasoseptal Flaps

New Table: 09X – Ear, Nose, Sinus, Transfer
Specifically for using nasoseptal pedicle flaps in skull base defect repairs — a technique frequently used in ENT and neurosurgery.

More New Codes You Should Be Watching

Let’s dig into some of the most noteworthy technology-driven additions making waves in procedural coding:

AV Fistula Support: Expandable Intraluminal Device

Code: X27x35B
Used to place the Wrapsody® endoprosthesis into dialysis patients’ AV fistulas. Helps extend fistula lifespan — a big win for long-term dialysis patients.

AI-Based Sepsis Triage

Code: XXEZXCB
Captures use of Sepsis ImmunoScore, the first FDA-approved AI tool to assist in early sepsis diagnosis using patient biomarkers.

Device Removal from Dura or Spinal Meninges

🦴SI Joint Fusion & Pelvic Fixation with iFuse TORQ TNT™

Codes: XRGxxHB, XNSxxHB, XNHxxHB
For coding placement of a bone-density-specific implant, especially useful for patients with osteoporosis or compromised bone quality.

Endovascular Anchors for Aneurysm Repair

Code: 0xU03LZ
Captures placement of endoanchors during EVAR procedures. These tiny implants stabilize the graft in “hostile” aortic anatomies — not sutures, but permanent fixtures.

Radiofrequency Leaflet Laceration Pre-TAVR

Code: X28F3WB
For high-risk TAVR cases where TELLTALE RF System is used to split the aortic valve leaflet, preventing coronary obstruction.

Custom Cervical Spinal Fusion

Code: XRGxxRB
Expands use of the aprevo® custom 3D-printed spinal fusion device to the cervical spine, designed for a perfect patient-specific fit.

Radiofrequency Ablation for Pulmonary Hypertension

Code: X05233B
Captures use of Pulnovo® RF catheter system to ablate the cardiac plexus, reducing sympathetic overactivity — a hallmark of pulmonary hypertension. Iloprost for Severe Frostbite

Code: XW0x3QB
This IV drug helps reduce the risk of digit amputation. Administered as an inpatient-only drip, 8-day protocol, via peripheral or central vein.

New Drug Therapy for Schizophrenia- ICD-10-PCS 2026 Code Updates/changes

Code: XW0DXVB
COBENFY™ (xanomeline + trospium chloride) introduces a new treatment approach that targets muscarinic receptors, showing promise in addressing both positive and negative symptoms of schizophrenia.

What Should Coders Do Now?

Get Familiar with the Tables – Many of these changes involve new body part characters, devices, and qualifiers.
Look Out for NTAP Expirations – Several codes were deleted due to NTAP status changes.

Final Thoughts

This 2026 ICD-10-PCS updates highlight how fast medical technology is evolving — and how critical it is for medical coders to stay current. Whether you’re coding AI-assisted diagnostics, 3D-printed implants, or novel surgical techniques, these codes tell the story of modern medicine. Be sure to update your references, practice documentation alignment, and inform your providers of key changes that impact reporting and reimbursement.

ICD-10-PCS 2026 Code Updates: What Medical Coders Need to Know