CMS introduces dedicated CPT Codes for Prostate Biopsy Techniques
This major update improves Access, Accuracy, and Reimbursement
As of January 1, 2026, CMS (Centers for Medicare & Medicaid Services in the USA) has implemented a significant update to prostate biopsy coding under the Hospital Outpatient Prospective Payment System (OPPS), as published in the January 2026 Addendum B.
This update marks a clear shift away from the historical single-code approach toward a method-specific CPT structure, recognizing the clinical and technical differences between prostate biopsy techniques — including a specific code for in-bore MR-guided prostate biopsy.
From One Code to Method-Specific Recognition
Until 2025, prostate biopsies were reported using a single CPT code (55700), regardless of Imaging guidance, Biopsy approach or Procedural complexity!
This approach did not differentiate between conventional systematic biopsy, or targeted MR-US fusion, or in-bore MRI-guided prostate biopsy procedures, limiting alignment between clinical value and reimbursement.
Starting in 2026, CMS now recognizes 9 distinct CPT codes, each reflecting a specific biopsy method. This expanded coding structure formally acknowledges that not all prostate biopsies are equal — clinically, technically, or operationally
