News and guides · October 14, 2026
CMS's October 2026 HCPCS Update Adds 45 Codes, Ends 15 and Shrinks Drug Units
CMS's October 2026 HCPCS Level II quarterly update took effect Oct. 1, 2026, with 45 new codes, 15 discontinued codes and smaller billing units for several drugs.
Key takeaways
- The October 2026 HCPCS Level II update took effect Oct. 1, 2026, with 45 added codes, 15 discontinued codes, 11 long-description changes, 5 payment changes and 1 administrative field change.
- About 10 drug codes were discontinued and replaced with new codes that use smaller billing units, such as 1 mg, 5 mg, 10 mg or 0.01 mg. Units reported on claims must change to match.
- Several temporary hospital outpatient C-codes for drugs now have permanent J-codes with the same description, and the old C-codes are discontinued.
- Many printed code books won't show these codes until the January 2027 edition, even though the codes are already in use on claims.
- CMS posted a Corrections file with 3 entries, which shows a quarterly file can change after it is first posted.
What changed on Oct. 1, 2026
CMS's October 2026 HCPCS Level II quarterly update took effect Oct. 1, 2026. The Transaction Report in the CMS data file has 9,154 rows: 45 added codes, 15 discontinued codes, 11 long-description changes, 5 payment changes, 1 administrative field change and 9,077 unchanged codes.
The 45 new codes break down by series as J 23, A 8, Q 5, C 3, L 3, E 2 and G 1. All of them have an action effective date of Oct. 1, 2026. The 15 discontinued codes break down as J 10, C 4 and L 1. Two examples, a C-code and the old trabectedin J-code, show an end date of Sept. 30, 2026 and an action effective date of Oct. 1, 2026.
Smaller billing units for several drugs
For about 10 drug codes, CMS discontinued the old code and added a new one with a smaller billing unit. Leucovorin calcium moved from per 50 mg to a not-otherwise-specified 1 mg code. Furosemide (Furoscix) moved from 20 mg to 1 mg. Levetiracetam moved from 10 mg to 5 mg, and there is also a new 5 mg code for levetiracetam in sodium chloride.
Four mycophenolate mofetil codes changed to 5 mg units: oral (from 250 mg), injection (from 10 mg), for suspension (from 100 mg) and Myhibbin (from 100 mg). Etoposide moved from 10 mg to 1 mg, fluorouracil from 500 mg to 10 mg, and trabectedin from 0.1 mg to 0.01 mg.
Separately, three temporary C-codes now have J-codes with the same descriptions: cocaine hydrochloride nasal solution (Goprelto), 1 mg; leucovorin calcium (Avyxa), 1 mg; and delafloxacin, 1 mg. The file does not call these crosswalks. They are paired here only because the descriptions match.
New products, supplies and services
New drug and biologic codes include brand-specific Avyxa codes for bendamustine, etoposide and fluorouracil, and two biosimilars: filgrastim-laha (Filkri) and denosumab-adet (Ponlimsi). Two new codes are described as not therapeutically equivalent to another code: daptomycin (Endo) and trabectedin (Apotex).
New skin substitute and wound-care codes include per sq cm add-on codes for Dermisphere hdrt, Lacertamatrix, Theracor, Carbon Life, Dermabind SL Optic and Amchomatrix, plus per milligram codes for PuraPly MZ and a fibrillar collagen wound dressing. Other additions cover an ambulatory infusion pump for a specific device-drug combination, an external ocular negative pressure pump and its monthly supplies, and two off-the-shelf orthoses.
A new G-code describes an algorithm-based assessment of how likely autism spectrum disorder is, based on analysis of eye-gaze data or other technology.
Inside the CMS file
The CMS quarterly update page says the effective date is noted in the file title. It lists the October 2026 Alpha-Numeric HCPCS File as updated Sept. 23, 2026. The ZIP contains the full code file in text and spreadsheet formats, a Transaction Report dated Sept. 26, 2026, a Corrections file, a record layout, a list of not-otherwise-classified codes and a file of procedure notes. CMS no longer publishes a separate Table of Drugs or HCPCS Index with quarterly updates, because the electronic files can be searched and sorted.
The 5 payment changes apply to wound products. Their action effective date is April 1, 2026, and their pricing indicator is now 11, which the record layout defines as "Price established using national rvu's." The file does not show their previous pricing. The Corrections file has 3 entries, all effective Oct. 1, 2026: one C-code terminated, one J-code added and one orthosis long description revised.
What it means for exam prep and daily coding
On the job, check the billing unit in each drug code's description every time. If a drug moved from 50 mg to 1 mg, the number of units you report has to change, or payment will be wrong. Don't rely only on a printed book for drugs given on or after Oct. 1, 2026. Many books won't include these codes until the January 2027 edition.
For study, the CMS quarterly file is good practice material. Use the Transaction Report to find what was added, discontinued or revised, read the record layout to decode fields such as pricing indicators, and check the Corrections file for late changes.