Changes in the OPCS procedure coding classification to take effect in April 2026 in England

In November 2025, the Terminology and Classifications Service at NHS England released a final summary of core changes between OPCS-4.10 and OPCS-4.11. OPCS-4 is the clinical coding classification of interventions and procedures undertaken within the NHS. It is updated every three years to reflect current NHS clinical practice, for use in statistical purposes and for reimbursement. OPCS version 4.11 is expected to take effect on April 1, 2026.

NHS England receives OPCS-4 requests for change via the Requests Submission Portal. A total of 747 requests for change were evaluated for OPCS-4.11. A consultation on draft changes was carried out in July 2025.

The key final changes between OPCS-4.10 and OPCS-4.11 comprise the following:

• Introducing 65 new three-character (category) codes and 572 new four-character (subcategory) codes;
• Removing seven three-character codes and 73 four-character codes;
• Changes of 57 three-character and 419 four-character code descriptions;
• Multiple changes to notes related to chapters or codes.

New procedure codes were implemented in various fields, including cardiovascular, peripheral vascular, diagnostic imaging, endoscopy, ENT, dermatology, ophthalmology, gastroenterology, urology and nephrology, obstetrics and gynecology, men’s health, neurology and neurosurgery, neuromodulation, orthopedics, spine, pulmonary and airways, interventional radiology, surgical procedures, and radiotherapy.

Some examples of newly introduced codes are provided below:

• A36.6 Pulsed radiofrequency to cranial nerve;
• C84.7 Subretinal injection of therapeutic substance;
• E67.2 Endoscopic insertion of endobronchial valve (Includes: Endoscopic reduction of lung volume using endobronchial valve);
• K50.6 Percutaneous transluminal lithotripsy of coronary artery; 
• K70.1 Implantation of intravenous single chamber leadless cardiac pacemaker system under new sub-chapter K70 “Leadless cardiac pacemaker system introduced through vein”;
• K51.4 Percutaneous transluminal optical coherence tomography of coronary artery;
• L63.6 Percutaneous transluminal lithotripsy of femoral artery;
• M65.7 Endoscopic ablation of prostate using waterjet;
• R30.6 Balloon tamponade of delivered uterus;
• R44.2 Continuous fetal electrocardiography monitoring using fetal scalp electrodes;
• X69.6 Delivery of a fraction of stereotactic external beam radiotherapy.

The full details can be found here.

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