The American Medical Association released the CPT 2027 code set yesterday evening, September 9, 2026. The headline numbers are 299 new codes, 74 revised codes and 80 deletions, 453 changes in all, effective for dates of service on or after January 1, 2027. That is a moderate year by volume. It is not a moderate year for obstetrics, and it is the first year where the artificial intelligence section is large enough that ordinary practices need to know it exists.
We spent the first day with the release doing what we always do: reading the deletions before the additions. New codes are opportunities. Deleted codes are denials waiting for January 2, because every charge master, every EHR favorite list and every payer contract that references a deleted code will produce a rejected claim until someone fixes it. Here is what we found and how we'd plan the next twelve weeks.
Key takeaways
- The global maternity packages (59400, 59510, 59610, 59618 and their component codes) are deleted; antepartum and postpartum care move to E/M codes, with new codes for labor management and delivery.
- Ten new AI service codes bring that family to 43, and the taxonomy in Appendix S now decides which code fits the software you bought.
- Read deletions first: every deleted code in a charge master, superbill, favorites list or contract is a January denial.
- CMS has proposed 15 G codes that would keep a global-style maternity payment for Medicare; the final rule around November 1 settles it.
What changed, by area
| Area | What the release does | Who feels it |
|---|---|---|
| Maternity care services | Section restructured: 17 codes deleted and 12 added. The global packages (59400, 59510, 59610, 59618) and the antepartum bundles (59425, 59426) are gone in favor of phase-based reporting | OB/GYN, family medicine practices that deliver, midwifery groups, and every biller who has ever posted a global OB payment |
| Artificial intelligence services | 10 new codes, bringing the AI total to 43; Appendix S (the AI taxonomy of assistive, augmentative and autonomous) updated | Cardiology, radiology, ophthalmology and any practice using software that reads images or signals |
| Hernia repair | 9 new codes for diaphragmatic hernia procedures | General and thoracic surgery |
| Sleep medicine | 6 new codes for unattended sleep studies | Sleep centers, pulmonology, neurology |
| Ventricular assist devices | 3 new codes for left VAD procedures | Cardiothoracic surgery, heart failure programs |
| Radiology | New and revised codes across imaging sections | Imaging centers, radiology groups |
| Prostate biopsy and biofeedback | Revised and new codes | Urology, pelvic floor and physical therapy programs |
The usual scattering of revised descriptors touches most specialties somewhere. If you bill it, read the section, not the summary.
The maternity change deserves its own meeting
For decades an uncomplicated pregnancy was billed as one code after delivery. Starting January 1, 2027, the global packages are gone. Antepartum visits are reported with standard evaluation and management codes as they happen. Labor management becomes its own service, with codes for the initial day (59080, 59081) and subsequent days (59082, 59083). Delivery has its own codes for vaginal and cesarean birth, and postpartum care is reported with E/M codes.
The AMA released this section ahead of the rest of the set precisely because the transition is large. In practice it changes three things at once. Cash flow moves earlier, because antepartum visits are billed as they happen instead of accruing to a payment after delivery. Documentation must support each E/M visit on its own, which most OB notes were never written to do. And every payer contract with a global OB rate needs a conversation, because the code the rate is attached to will not exist.
A worked example shows the cash flow shift. Suppose a commercial payer has been paying $3,200 for 59400, received about six weeks after a delivery. Under the new structure the same pregnancy might produce eleven antepartum E/M visits billed from month two onward, a labor management claim and a delivery claim in the delivery month, and two postpartum E/M visits after. If those eleven visits average $110 in allowed amount, roughly $1,200 arrives during the pregnancy rather than after it, and the rest depends on what the payer sets for the new labor and delivery codes, which nobody knows yet. The point is not the total. It is that the practice's monthly revenue pattern changes in January, and the antepartum documentation has to earn each of those E/M levels on its own.
There is one open question. CMS has proposed, in the CY 2027 Physician Fee Schedule proposed rule, 15 new HCPCS G codes that would preserve a global-style payment for Medicare maternity care alongside the CPT restructure, and the comment period on that proposal closes September 14. Medicare is a small share of most OB practices, but commercial payers often follow CMS structure, so watch the final rule, expected around November 1, before deciding how to set up the charge master.
The AI codes are not just for radiologists
Ten new codes and an updated Appendix S mean the taxonomy is stabilizing. Appendix S sorts AI-enabled services into assistive (the software detects or highlights), augmentative (the software analyzes and quantifies) and autonomous (the software interprets and produces a result). The category determines which code applies and, increasingly, whether a payer covers it at all. If your practice has bought software this year that reads retinal images, flags arrhythmias on a wearable, or quantifies coronary plaque, someone needs to check whether a 2027 code describes what it does and what your payers say about it. Most say nothing yet, which means most claims will deny until policies catch up. We think practices should bill these correctly anyway, because a denial with the right code establishes a record and a wrong code is a compliance issue.
A twelve-week plan
- Weeks of September 14 and 21. Download the code set changes. Run every deleted code against your charge master, EHR favorites, order sets and superbills. Produce a list of every place each deleted code appears.
- Week of September 28. Coders read the full sections for your specialties, not the summary. Identify revised descriptors that change what documentation must contain.
- October. Build the crosswalk from deleted to replacement codes. For maternity, decide the antepartum E/M documentation standard and train providers on it. Ask each major payer, in writing, how they will handle deleted codes with a 2027 date of service and whether new codes have a coverage policy.
- Weeks of November 2 and 9. Read the CY 2027 PFS final rule when it publishes. Load the 2027 codes into the practice management system in a test environment and confirm the claim scrubber recognizes them.
- Weeks of November 16 through December 11. Update charge master, fee schedule and templates in production, effective-dated January 1. Update payer contract references where the payer agrees.
- Week of December 14. Train front-line staff on what changes on the first claim of the year. Confirm that claims for December dates of service still use 2026 codes even when submitted in January.
The plan assumes one person owns it. In small practices that is usually the lead coder or the practice manager; in ours it is the coding lead assigned to the practice. Whoever it is needs the authority to change the charge master and the fee schedule, because the plan fails at step five when the person who found the problems is not the person allowed to fix them.
The mistakes we expect to see in January
Templates updated before January 1 without effective dating, so December visits go out with 2027 codes and deny. Global OB packages billed in January for deliveries in December, which is actually correct (the date of service governs), but confuses payers that loaded the new set early. Practices that update the codes but not the fee schedule, so new codes go out with a zero charge. And the perennial one: nobody tells the person who builds the superbill.
One more that is specific to this year. Pregnancies that span the change. A patient whose antepartum care began in September 2026 and who delivers in February 2027 cannot be billed with a global code, because the global code will not exist on the date of delivery. The antepartum visits before January 1 fall under the old rules and the visits and delivery after it fall under the new ones, and payers will have their own instructions for the straddle. Ask each OB payer now how it wants those pregnancies reported, and get the answer in writing.
Our live coding courses cover the 2027 changes in November, and practices that use our coding services receive the specialty crosswalk as part of the year-end update. For the specific question of maternity coding, we'd encourage OB practices to start the documentation work now regardless of who does their billing.
Questions we hear
Can we start using 2027 codes early if a payer accepts them?
No. CPT codes are effective by date of service, and a 2027 code on a 2026 service is a coding error even if the payer's system pays it. Payers do recoup these.
Will the maternity change reduce OB payment?
It depends on the payer and on how well the antepartum visits are documented. Billed correctly, the sum of the phases can be close to the old global; billed as habitual level 2 visits with thin notes, it will not be. This is a documentation project as much as a coding one.
Do we need the AMA codebook or is the summary enough?
You need the full text for your sections. Descriptor revisions and parenthetical notes are where the billing rules live, and summaries leave them out.
What to do this week
- Obtain the CPT 2027 changes file and export the 80 deleted codes to a spreadsheet.
- Search the charge master, superbills, EHR favorites and order sets for each deleted code and record every hit.
- List every payer contract that names a specific CPT code in its rate schedule, and flag the ones that name a deleted code.
- If you provide obstetric care, schedule the maternity meeting with providers, coders and the front desk for the week of September 21.
- Name the owner of the twelve-week plan and put the six checkpoints on the practice calendar.
