Latest Updates on Pathology CPT Codes 2026

Pathologists rely on standardized CPT codes to report laboratory and surgical pathology services accurately. The AMA’s 2026 CPT code set introduces dozens of new pathology and laboratory codes, revises many existing codes, and deletes obsolete ones. Healthcare providers and pathology billing services must update their coding manuals and billing systems to reflect these changes. In 2026, the AMA added 288 new CPT codes (nearly a quarter in lab testing and molecular diagnostics), deleted 84 codes, and revised 46 codes across all specialties. Many of the new codes involve advanced genomic or infection-related tests used in pathology and laboratory medicine. Keeping up with these updates is critical: accurate use of pathology CPT codes ensures correct reimbursement for labs and pathologists and helps avoid denials or audits.

2026 Pathology CPT Code Changes (Pathology & Laboratory)

CPT 2026 includes several changes to the CPT codes for pathology and laboratory services. Key Category I additions include:

Codes	Description
81354	Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy-number variants, optical genome mapping (OGM).
81524	Oncology (central nervous system tumor), DNA methylation analysis of ≥10,000 methylation sites using tumor tissue, with algorithms reporting family/class match probability and MGMT promoter methylation status.
87182	Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (e.g., KPC, NDM, VIM), multiplex qualitative immunoassay, per isolate.
87183	Susceptibility studies, antimicrobial agent; carbapenem resistance genes (e.g., blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP), amplified probe technique, per isolate.
87494	Infectious agent detection by nucleic acid (DNA or RNA), Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique.
87627	Infectious agent detection by nucleic acid (DNA or RNA); joint space pathogens and drug-resistance genes, multiplex amplified probe technique (26 or more targets).
87812	Infectious agent antigen detection by immunoassay with direct optical (visual) observation; SARS-CoV-2 and influenza A/B.

In addition, new Category III (Proprietary Laboratory Analyses) codes relevant to laboratory medicine were introduced. Notable new U-codes for 2026 include:

Codes	Description
0603U	Endocrinology (insulin and C-peptide immunoassay, and HbA1c), with an algorithmic diabetes-risk score.
0604U	Drug testing, presumptive, 77 drugs/metabolites (urine) by LC-MS/MS, reported qualitatively.
0605U	Allergy/immunology (chronic recurrent angioedema), quantification of 4 bradykinin peptides in whole blood by LC-MS/MS.
0606U	Allergy/immunology (hereditary alpha tryptasemia), TPSAB1 gene copy-number analysis (digital PCR) in whole blood.
0607U	Reproductive medicine (endometrial microbiome), PCR analysis for 31 bacterial DNA targets from biopsy with quantification and treatment recommendations.
0608U	Reproductive medicine (endometrial microbiome), PCR analysis for 10 bacterial DNA targets from biopsy with quantification and treatment recommendations.
0609U	Oncology (prostate), total and free PSA immunoassay (serum/plasma) combined with clinical factors (age, biopsy history, etc.) to generate a prostate cancer risk score.
0610U	Infectious disease (antimicrobial susceptibility), phenotypic susceptibility testing of positive blood culture using microfluidic sensor technology (quantifying growth response to antibiotics).
0611U	Oncology (liver), analysis of >1000 methylated regions in plasma cell-free DNA, algorithmic quantitative report.
0612U	Oncology (liver), analysis of >1000 methylated regions in plasma cell-free DNA, algorithmic quantitative report (similar to 0611U).
0613U	Oncology (urothelial carcinoma), urine DNA methylation and mutation analysis of six biomarkers (TWIST1, OTX1, ONECUT2, FGFR3, HRAS, TERT), algorithmic probability index for bladder/upper-tract carcinoma.

Deleted CPT Codes (effective 12/31/2025)

Several pathology-related codes were deleted for 2026. Notably, Category I Proprietary Lab Analysis codes (U-codes) removed include:

• 0033U
• 0131U
• 0132U
• 0135U
• 0361U
• 0508U
• 0509U
• 0544U
• 0550U
• 0551U

These were Category III codes for various genetic and biomarker tests (e.g., 0033U for HTR2A/2C gene analysis, 0131U-0135U for hereditary cancer panels, 0361U for neurofilament light, 0508U/0509U for donor-derived cell-free DNA, 0544U for transplant monitoring, 0550U for prostate cancer PSA assay, 0551U for plasma pTau217).

In addition, two Category I PLA codes were deleted:

• 0450U
• 0451U 

All the above codes were deleted and should no longer be used as of 1/1/2026.)

Revised CPT Codes (2026)

Two existing pathology codes were editorially revised (changes in descriptors):

These revised descriptors (83015, 83018) reflect only editorial changes in the example elements. No other pathology/lab CPT codes were revised in 2026.

Key Pathology CPT Codes and Their Usage

Even as new codes emerge, many core CPT codes for pathology and laboratory services remain constant. It’s important to understand these foundational codes, since updates often build upon them; for example, the digital add-ons attach to existing codes. Here we’ll cover several important codes which are also popular search terms in pathology billing, and note any recent changes or related updates:

Surgical Pathology Procedure CPT Codes (88300–88309)

Codes 88300 through 88309 represent the six surgical pathology service levels, from level I (minimal examination) to level VI (most complex). These are the bread-and-butter codes for pathologists examining tissue specimens. According to the code definition:

• 88300 CPT code description

Level I surgical pathology, gross examination only. The 88300 pathology CPT code covers the initial steps of preparing a specimen for gross exam without any microscopic analysis. This might be used for a specimen that doesn’t require microscopy (e.g., a tooth or a foreign body).

• 88302 – 88309 Codes

Level II through VI surgical pathology, gross and microscopic examination of increasing complexity. Each higher level is assigned based on the specimen type or complexity. For example, 88304 CPT code (Level III) typically covers specimens like cysts or polyps requiring gross & micro exam.

• CPT code 88305 (Level IV)

It is one of the most commonly used codes for specimens like routine biopsies and excisions (e.g., skin biopsies) that involve moderate complexity exam.

• CPT code 88307 (Level V)

It is used for more complex specimens, such as a simple mastectomy (without lymph nodes).

• 88309 CPT code (Level VI)

It indicates the highest complexity, e.g., a radical resection specimen requiring extensive study.

Intraoperative Consultation Codes (88331, 88332)

Pathologists often provide rapid consultations during surgery (i.e., frozen section analysis) to inform the surgeon’s immediate decisions. The CPT coding for intraoperative consultations is:

• CPT code 88331

Pathology consultation during surgery; first tissue block, with frozen sections, single specimen. This is used for the first specimen on which a frozen section exam is performed.

• CPT 88332

Each additional tissue block with frozen sections is for additional specimens beyond the first. Essentially, you code 88331 once per case for the first specimen, and 88332 for each additional block examined.

Pathology Consultation Codes (88321, 88323, 88325)

Sometimes a pathologist is asked to render a second opinion or consult on materials from elsewhere. CPT provides codes for such consultations on referred slides or specimens:

• CPT code 88321

Consultation and report on referred slides prepared elsewhere. This is used when another lab’s slides are sent for an expert opinion, and the consulting pathologist issues a report on those slides.

• CPT 88323

Consultation and report on referred material requiring preparation of slides. This code is used if the referred material is not pre-prepared slides, for example, a tissue block or wet tissue that requires new slide preparation and staining by the consulting lab. The pathologist then examines those newly made slides and reports the findings.

• CPT 88325

Comprehensive consultation with review of records and specimens. This represents a more extensive consult (including review of the patient’s clinical records, multiple specimens, etc.).

Immunohistochemistry Codes (88341, 88342, 88344)

Immunohistochemistry (IHC) is a common lab technique where antibody stains are applied to tissue sections to detect specific antigens (e.g. to classify tumors). The primary CPT codes for IHC are:

• 88342 CPT Code Description

Immunohistochemistry or immunocytochemistry, initial single antibody stain per specimen. This code is billed once for the first antibody stain performed on a specimen (regardless of how many slides it’s applied to, it’s per specimen).

• CPT 88341 CPT Code Description

Each additional single antibody stain on the same specimen (this is an add-on code). For example, if two different IHC stains are done on one biopsy, you would bill CPT 88342 for the first stain and CPT 88341 for the second.

• 88344

Each multiplex antibody stain procedure. This is used if a combined cocktail of antibodies is applied in one staining procedure (e.g. a multiplex immunostain that labels multiple markers at once). In practice, 88344 is less common than single stains, but it has its specific use.

Other Notable Codes and Concepts

• Special Stains (88312–88314, 88319)

Apart from IHC, there are special stain codes for histochemistry (e.g. 88312 for microorganism stains like AFB, 88313 for special stains etc.).

• Molecular (Genetic) Testing Codes

The CPT code set includes Tier 1 molecular pathology codes for specific genes (e.g. codes in the 811XX-814XX range for tests like BRCA1 analysis, EGFR gene analysis, etc.), Tier 2 codes for less common genes, and Genomic Sequencing Procedure (GSP) codes for multigene panels, plus Proprietary Lab Analyses (PLA) codes.

• Surgical Pathology Modifiers and Components

Remember that many pathology codes can be billed with professional (-26) or technical component (-TC) modifiers if the services are split between physician and lab. The CPT updates haven’t altered this, but correct use of modifiers remains a point of emphasis in pathology billing (e.g., never billing both -26 and -TC on the same line, etc.).

Billing and Compliance Considerations

Keeping pathology claims compliant with 2026 CPT updates involves several best practices:

• Update charge masters and fee schedules by 1/1/2026

Add the new codes (e.g. 87494, 87183, 81354, etc.) and remove deleted ones (0450U, 0451U). Ensure LIS/EMR orderables match the new CPT codes. APS Medical Billing recommends posting a “changelog” and retraining staff on annual CPT changes.

• Validate code usage with ICD-10

Each lab order must have appropriate ICD-10 diagnoses for medical necessity. Pathology billing services should verify that NCDs/LCDs have not added restrictions for certain tests.

• Apply correct modifiers

In pathology, ‑26 (professional component) and ‑TC (technical component) designate who is billing (pathologist vs facility). For example, hospitals typically bill 88305‑TC for the technical lab work, while pathologists bill 88305‑26 for interpretation. Labs must assign these properly to avoid duplicate billing or denials. Also use modifier 90 for reference lab tests, and separate codes (88172–88173) correctly for immediate adequacy and final interpretation of FNAs.

• Monitor Medicare rules

CMS’s 2026 Physician Fee Schedule modestly increases pathology reimbursements (~0.5% increase overall), but new policies (efficiency adjustment, site-of-service differential) could affect payments. Check if any specific pathology test codes have Local Coverage Determinations changes. For example, Path code consult rules remain: only one consult per case.

• Plan for stakeouts

Some labs rely on pathology billing services or consultants to catch these updates. Some vendors often publish detailed guides for new CPT changes. The College of American Pathologists also provides fee schedule tools and may note major pathology code changes for Medicare.

Conclusion

The 2026 CPT updates bring major changes to pathology and laboratory coding. Providers must update their systems, fee schedules, and workflows on time. Accurate code selection is critical for clean claims and proper reimbursement. Pathology billing services should ensure correct ICD-10 linkage and modifier use. When no specific code exists, the unlisted molecular pathology procedure must be reported correctly. Staying current helps reduce denials, avoid audits, and protect pathology revenue.