Urology CPT Codes for 2026 + Modifiers

Urology billing covers everything from routine office visits to diagnostic cystoscopy and high-dollar surgeries—often in the same episode of care. That variety is exactly why consistent documentation, clean coding, and smart modifier use matter so much in 2026. If your team is still working from last year’s favorites list, this update will help you align your most common urology CPT codes and modifiers for 2026 with today’s coding landscape.

If you want a deeper revenue-cycle view (beyond codes), explore dedicated urology medical billing services.

Evaluation and Management Codes Common in Urology

Most urology encounters start (and often end) with E/M services. Even when a procedure occurs on the same date, payers expect E/M documentation to clearly stand on its own if it is billed separately.

Common Urology Office Procedures and Endoscopy Codes

This table highlights high-frequency office and endoscopic procedures that often drive denials when documentation or modifiers are incomplete.

Critical Update: As of January 1, 2026, CPT® 55700 has been deleted and can no longer be billed. It has been replaced by a more granular family of prostate biopsy codes (55707–55715) that bundle imaging guidance and distinguish between systematic and targeted approaches.

Urology Diagnostic Testing CPT Codes To Know

Diagnostic testing is a frequent denial trigger in urology, particularly when medical necessity or prior conservative management is not clearly documented.

Common Surgical Procedures and 2026 New Standards

The 2026 CPT® set includes the transition of Aquablation to a Category I code and a complete restructuring of prostate biopsy reporting.

A Quick 2026 “Watch List” for Urology Teams

The deletion of 55700 is the most impactful coding change for 2026. Practices should also ensure they have transitioned from the Category III “T” code (0421T) to the Category I code (52597) for Aquablation. Using deleted codes like 55700 will trigger invalid-code rejections, and failing to adopt the new prostate biopsy code family can increase denials and payer requests for additional documentation.

Urology Billing Modifiers That Prevent Denials

Common ICD-10-CM Codes Used in Urology

Urology Billing Tips for 2026

• Retire 55700. Ensure clinical and billing templates are updated to the new biopsy code family.
• Separate the story. Standalone E/M documentation is essential when billing alongside procedures.
• Update Aquablation coding. Use 52597 for 2026 claims instead of 0421T.
• Validate biopsy approach. Documentation must clearly support transrectal vs. transperineal technique and targeted lesions.

Final Thoughts

Keeping your urology CPT codes and modifiers for 2026 current helps protect reimbursement, reduce denials, and keep your practice audit-ready. Building an annual code review into your workflow ensures billing accuracy as CPT® standards continue to evolve.

For informational purposes only.