Aquablation® Therapy’s Assigned Category I Code in 2026 Medicare Proposed Physician Fee Schedule
Rhea-AI Summary
PROCEPT BioRobotics (Nasdaq: PRCT) announced that its Aquablation therapy has been assigned a Category I CPT code (52XX1) effective January 1, 2026, replacing the current Category III code 0421T. The 2026 Medicare Proposed Physician Fee Schedule assigns 16.14 total RVUs to Aquablation therapy, translating to approximately $540 in national average payment, slightly higher than TURP's 15.82 RVUs ($529).
This milestone recognition reflects Aquablation therapy's clinical value and widespread adoption in BPH surgical treatment. The proposed payment rates are subject to a public comment period ending September 2025, with the Final Rule expected in November 2025.
Positive
- Upgrade to Category I CPT code status validates clinical value and widespread adoption
- Proposed payment rate of $540 is higher than TURP's $529, supporting competitive positioning
- New code status may facilitate broader surgeon adoption and patient access
Negative
- Final payment rates subject to change after public comment period
- Implementation delayed until January 1, 2026
Insights
Aquablation therapy's upgrade to Category I CPT code signals mainstream acceptance and comparable reimbursement to standard TURP, boosting PROCEPT's market position.
PROCEPT BioRobotics just secured a significant regulatory win with their Aquablation therapy receiving a Category I CPT code effective January 2026. This represents a crucial evolution from its current Category III code status. For context, Category III codes are temporary codes assigned to emerging technologies, while Category I codes indicate mainstream acceptance and established clinical efficacy.
The assigned 16.14 total RVUs (Relative Value Units) translate to approximately
This reimbursement parity with TURP is particularly noteworthy as it removes a key barrier to adoption. Historically, physicians face financial disincentives when adopting new technologies that are reimbursed at lower rates than established procedures. With comparable reimbursement, the decision to use Aquablation can now be based primarily on clinical factors rather than economic ones.
The timing of this announcement gives stakeholders visibility into future payment structures well before implementation. While the final rule won't be released until November 2025 following the comment period, the proposed rates signal CMS's recognition of Aquablation's clinical value in the BPH treatment landscape.
This regulatory milestone strengthens PROCEPT's commercial position by facilitating broader adoption among urologists and expanding access for Medicare beneficiaries seeking surgical treatment for BPH with potentially fewer sexual side effects than traditional approaches.
SAN JOSE, Calif., July 14, 2025 (GLOBE NEWSWIRE) -- PROCEPT BioRobotics® Corporation (Nasdaq: PRCT) (the “Company”), a surgical robotics company dedicated to advancing patient care through transformative urology solutions, today announced that Aquablation therapy was assigned a Category I code effective January 1, 2026.
The 2026 Medicare Proposed Physician Fee Schedule (PFS) includes payment rates for a new Category I Current Procedural Terminology (CPT) code related to Aquablation therapy. Category I CPT code 52XX1 will replace Category III CPT code 0421T as the primary code for Aquablation therapy.
“Securing a Category I CPT Code marks a major milestone for PROCEPT, the urology community, and the patients we serve,” said Sham Shiblaq, chief commercial officer of PROCEPT BioRobotics. “This transition recognizes the clinical value and widespread use of Aquablation therapy as we continue to make progress toward becoming the BPH surgical standard of care. The Category I code will further support surgeon adoption and broaden patient access to a treatment that delivers durable symptom relief with a low risk of sexual side effects.”
The new CPT Category I Code 52XX1 was assigned a 2026 national Medicare physician proposed payment of 16.14 total RVUs which translates to an approximate national average of
The PFS Proposed Rule was released on July 14, 2025, and updated payment policies and payment rates for services will be provided for Medicare beneficiaries on or after January 1, 2026. The Proposed Rule release is followed by a public comment period that will close in September 2025 and will culminate in CMS' release of the Final Rule, which is expected to be announced in November 2025 for implementation on January 1, 2026. The Proposed Rule is therefore subject to change.
These 2026 proposed rule payment values and RVU assignments can be viewed on the CMS website at: https://www.cms.gov/medicare/payment/fee-schedules/physician/federal-regulation-notices/cms-1832-p
About Aquablation Therapy
Aquablation therapy is the first and only ultrasound guided, robotic-assisted, heat-free waterjet for the treatment of BPH. The system’s real-time ultrasound imaging provides the surgeon with a multi-dimensional view of the prostate enabling personalized treatment planning tailored to each patient’s unique anatomy. The surgeon can specify which areas of the prostate to remove while preserving the anatomy that controls erectile function, ejaculatory function and continence. Once the treatment plan is mapped by the surgeon, the predictable robotic-assisted execution enables prostate tissue to be removed in a precise, targeted and controlled fashion.
About PROCEPT BioRobotics Corporation
PROCEPT BioRobotics is a surgical robotics company focused on advancing patient care by developing transformative solutions in urology. PROCEPT BioRobotics manufactures the AQUABEAM® and HYDROS™ Robotic Systems. The HYDROS Robotic System is the only AI-powered, robotic technology that delivers Aquablation therapy. PROCEPT BioRobotics designed Aquablation therapy to deliver effective, safe, and durable outcomes for males suffering from lower urinary tract symptoms or LUTS, due to BPH that are independent of prostate size and shape or surgeon experience. BPH is the most common prostate disease and impacts approximately 40 million men in the United States. The Company has developed a significant and growing body of clinical evidence with over 150 peer-reviewed publications, supporting the benefits and clinical advantages of Aquablation therapy.
Forward-Looking Statements
This press release may contain forward-looking statements within the meaning of federal securities laws. Forward-looking statements are subject to numerous risks and uncertainties that could cause actual results to differ materially from those anticipated or implied in such statements. PROCEPT BioRobotics undertakes no obligation to publicly update or revise any forward-looking statements.
Important Safety Information
All surgical treatments have inherent and associated side effects. For a list of potential side effects visit https://aquablation.com/safety-information/
Investor Contact:
Matt Bacso
VP, Investor Relations and Business Operations
m.bacso@procept-biorobotics.com
FAQ
What is the new Category I CPT code assigned to PRCT's Aquablation therapy?
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What is the significance of PRCT receiving a Category I CPT code for Aquablation therapy?
