News: FY 2027 ICD-10-PCS code set and guidelines released

CMS has published the fiscal year (FY) 2027 ICD-10-PCS code set and ICD-10-PCS Official Guidelines for Coding and Reporting. While CMS made no significant changes to the guidelines, the code set includes 101 new codes, 38 deleted codes, and one new table.

This update brings the FY 2027 ICD-10-PCS code set to a total of 79,256 codes available for discharges occurring from October 1, 2026, through September 30, 2027.

The new codes cover a range of procedures. These include the following tabular updates:

• New body part characters in table 028 for Division of aortic valve and mitral valve, with two new possible qualifier characters for native leaflet and prosthetic leaflet
• New device value in table 0RG for Fusion of thoracolumbar vertebral joint using a custom-made interbody fusion device, anatomically and virtually designed
• New device value in table 0SG for Fusion of lumbar vertebral joints and lumbosacral joint using a custom-made interbody fusion device, anatomically and virtually designed
• New qualifier value in table 0W9 for Drainage of pleural cavity and mediastinum using an active mechanical clearance drainage device
• New qualifier value in table 302 for Transfusion of high-dose immune globulin into peripheral and central vein
• New qualifier value in table 3E0 for Introduction of other enzymatic/chemical agent into skin and mucous membranes as well as subcutaneous tissue
• New function and qualifier value in table 5A0 for continuous Assistance with circulatory decompression using an impeller pump
• New qualifier value in table 5A1 for Performance of urinary filtration with a selective cytopheretic device
• New table for Other imaging procedures involving the eye

Fifty of the new codes fall under 13 new technology tables, one of which is a new table for procedures using new technologies for other procedures on physiological systems and anatomical regions. For example:

• XEZD3QC, Pericardial cavity access using blunt-tip concealed needle with mechanical gripping mechanism, percutaneous approach, new technology group 12
• XEZJ3NC, Coronary artery access using image-guided crossing and re-entry system, percutaneous approach, new technology group 12
• XEZU3HC, Computer-aided guidance for intraprocedural navigation using ultrasound imaging with continuous needle tracking in spinal canal, percutaneous approach, new technology group 12
• XEZZXJC, High dimensional mixture-of-experts computer-aided assessment of inflammatory response and organ function, for notification and triage, new technology group 12
• XEZZXLC, Computer-aided detection and notification for imaging abnormalities in echocardiography, new technology group 12
• XEZZXPC, Cardiac conduction mechanism, computer-aided guidance for three-dimensional intraprocedural navigation using fluoroscopic imaging, new technology group 12

All 38 deletions occur in new technology tables:

• X2K for bypass of cardiovascular system
• XD2 for monitoring of the gastrointestinal system
• XRG for fusion of joints
• XW0 for introduction into anatomical regions
• XW1 for transfusion into anatomical regions
• XXE for measurement of physiological systems

Editor’s note: To view the FY 2027 code set and guidelines in their entirety, click here. To find the full list of code additions, revisions, and deletions on the CMS website, download the order addenda in the 2027 ICD-10-PCS Order File (Long and Abbreviated Titles) (ZIP) file. To read additional coverage from JustCoding, click here.