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23 HCC

Prostate, Breast, and Other Cancers and Tumors

CMS Model V28 234 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 23)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC23 2026 + 0.196
CFD HCC23 2026 + 0.218
CNA HCC23 2026 + 0.186
CND HCC23 2026 + 0.233
CPA HCC23 2026 + 0.203
CPD HCC23 2026 + 0.237
INS HCC23 2026 + 0.197

Mapped ICD-10-CM Diagnoses (234)

The following diagnoses map directly to HCC 23 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
C43.0 Malignant melanoma of lip Notes ↗
C43.10 Malignant melanoma of unspecified eyelid, including canthus Notes ↗
C43.111 Malignant melanoma of right upper eyelid, including canthus Notes ↗
C43.112 Malignant melanoma of right lower eyelid, including canthus Notes ↗
C43.121 Malignant melanoma of left upper eyelid, including canthus Notes ↗
C43.122 Malignant melanoma of left lower eyelid, including canthus Notes ↗
C43.20 Malignant melanoma of unspecified ear and external auricular canal Notes ↗
C43.21 Malignant melanoma of right ear and external auricular canal Notes ↗
C43.22 Malignant melanoma of left ear and external auricular canal Notes ↗
C43.30 Malignant melanoma of unspecified part of face Notes ↗
C43.31 Malignant melanoma of nose Notes ↗
C43.39 Malignant melanoma of other parts of face Notes ↗
C43.4 Malignant melanoma of scalp and neck Notes ↗
C43.51 Malignant melanoma of anal skin Notes ↗
C43.52 Malignant melanoma of skin of breast Notes ↗
C43.59 Malignant melanoma of other part of trunk Notes ↗
C43.60 Malignant melanoma of unspecified upper limb, including shoulder Notes ↗
C43.61 Malignant melanoma of right upper limb, including shoulder Notes ↗
C43.62 Malignant melanoma of left upper limb, including shoulder Notes ↗
C43.70 Malignant melanoma of unspecified lower limb, including hip Notes ↗
C43.71 Malignant melanoma of right lower limb, including hip Notes ↗
C43.72 Malignant melanoma of left lower limb, including hip Notes ↗
C43.8 Malignant melanoma of overlapping sites of skin Notes ↗
C43.9 Malignant melanoma of skin, unspecified Notes ↗
C47.4 Malignant neoplasm of peripheral nerves of abdomen Notes ↗
C49.4 Malignant neoplasm of connective and soft tissue of abdomen Notes ↗
C49.A0 Gastrointestinal stromal tumor, unspecified site Notes ↗
C49.A1 Gastrointestinal stromal tumor of esophagus Notes ↗
C49.A2 Gastrointestinal stromal tumor of stomach Notes ↗
C49.A3 Gastrointestinal stromal tumor of small intestine Notes ↗
C49.A4 Gastrointestinal stromal tumor of large intestine Notes ↗
C49.A5 Gastrointestinal stromal tumor of rectum Notes ↗
C49.A9 Gastrointestinal stromal tumor of other sites Notes ↗
C50.011 Malignant neoplasm of nipple and areola, right female breast Notes ↗
C50.012 Malignant neoplasm of nipple and areola, left female breast Notes ↗
C50.019 Malignant neoplasm of nipple and areola, unspecified female breast Notes ↗
C50.021 Malignant neoplasm of nipple and areola, right male breast Notes ↗
C50.022 Malignant neoplasm of nipple and areola, left male breast Notes ↗
C50.029 Malignant neoplasm of nipple and areola, unspecified male breast Notes ↗
C50.111 Malignant neoplasm of central portion of right female breast Notes ↗
C50.112 Malignant neoplasm of central portion of left female breast Notes ↗
C50.119 Malignant neoplasm of central portion of unspecified female breast Notes ↗
C50.121 Malignant neoplasm of central portion of right male breast Notes ↗
C50.122 Malignant neoplasm of central portion of left male breast Notes ↗
C50.129 Malignant neoplasm of central portion of unspecified male breast Notes ↗
C50.211 Malignant neoplasm of upper-inner quadrant of right female breast Notes ↗
C50.212 Malignant neoplasm of upper-inner quadrant of left female breast Notes ↗
C50.219 Malignant neoplasm of upper-inner quadrant of unspecified female breast Notes ↗
C50.221 Malignant neoplasm of upper-inner quadrant of right male breast Notes ↗
C50.222 Malignant neoplasm of upper-inner quadrant of left male breast Notes ↗
C50.229 Malignant neoplasm of upper-inner quadrant of unspecified male breast Notes ↗
C50.311 Malignant neoplasm of lower-inner quadrant of right female breast Notes ↗
C50.312 Malignant neoplasm of lower-inner quadrant of left female breast Notes ↗
C50.319 Malignant neoplasm of lower-inner quadrant of unspecified female breast Notes ↗
C50.321 Malignant neoplasm of lower-inner quadrant of right male breast Notes ↗
C50.322 Malignant neoplasm of lower-inner quadrant of left male breast Notes ↗
C50.329 Malignant neoplasm of lower-inner quadrant of unspecified male breast Notes ↗
C50.411 Malignant neoplasm of upper-outer quadrant of right female breast Notes ↗
C50.412 Malignant neoplasm of upper-outer quadrant of left female breast Notes ↗
C50.419 Malignant neoplasm of upper-outer quadrant of unspecified female breast Notes ↗
C50.421 Malignant neoplasm of upper-outer quadrant of right male breast Notes ↗
C50.422 Malignant neoplasm of upper-outer quadrant of left male breast Notes ↗
C50.429 Malignant neoplasm of upper-outer quadrant of unspecified male breast Notes ↗
C50.511 Malignant neoplasm of lower-outer quadrant of right female breast Notes ↗
C50.512 Malignant neoplasm of lower-outer quadrant of left female breast Notes ↗
C50.519 Malignant neoplasm of lower-outer quadrant of unspecified female breast Notes ↗
C50.521 Malignant neoplasm of lower-outer quadrant of right male breast Notes ↗
C50.522 Malignant neoplasm of lower-outer quadrant of left male breast Notes ↗
C50.529 Malignant neoplasm of lower-outer quadrant of unspecified male breast Notes ↗
C50.611 Malignant neoplasm of axillary tail of right female breast Notes ↗
C50.612 Malignant neoplasm of axillary tail of left female breast Notes ↗
C50.619 Malignant neoplasm of axillary tail of unspecified female breast Notes ↗
C50.621 Malignant neoplasm of axillary tail of right male breast Notes ↗
C50.622 Malignant neoplasm of axillary tail of left male breast Notes ↗
C50.629 Malignant neoplasm of axillary tail of unspecified male breast Notes ↗
C50.811 Malignant neoplasm of overlapping sites of right female breast Notes ↗
C50.812 Malignant neoplasm of overlapping sites of left female breast Notes ↗
C50.819 Malignant neoplasm of overlapping sites of unspecified female breast Notes ↗
C50.821 Malignant neoplasm of overlapping sites of right male breast Notes ↗
C50.822 Malignant neoplasm of overlapping sites of left male breast Notes ↗
C50.829 Malignant neoplasm of overlapping sites of unspecified male breast Notes ↗
C50.911 Malignant neoplasm of unspecified site of right female breast Notes ↗
C50.912 Malignant neoplasm of unspecified site of left female breast Notes ↗
C50.919 Malignant neoplasm of unspecified site of unspecified female breast Notes ↗
C50.921 Malignant neoplasm of unspecified site of right male breast Notes ↗
C50.922 Malignant neoplasm of unspecified site of left male breast Notes ↗
C50.929 Malignant neoplasm of unspecified site of unspecified male breast Notes ↗
C50.A0 Malignant inflammatory neoplasm of unspecified breast Notes ↗
C50.A1 Malignant inflammatory neoplasm of right breast Notes ↗
C50.A2 Malignant inflammatory neoplasm of left breast Notes ↗
C54.0 Malignant neoplasm of isthmus uteri Notes ↗
C54.1 Malignant neoplasm of endometrium Notes ↗
C54.2 Malignant neoplasm of myometrium Notes ↗
C54.3 Malignant neoplasm of fundus uteri Notes ↗
C54.8 Malignant neoplasm of overlapping sites of corpus uteri Notes ↗
C54.9 Malignant neoplasm of corpus uteri, unspecified Notes ↗
C55 Malignant neoplasm of uterus, part unspecified Notes ↗
C60.0 Malignant neoplasm of prepuce Notes ↗
C60.1 Malignant neoplasm of glans penis Notes ↗
C60.2 Malignant neoplasm of body of penis Notes ↗
C60.8 Malignant neoplasm of overlapping sites of penis Notes ↗
C60.9 Malignant neoplasm of penis, unspecified Notes ↗
C61 Malignant neoplasm of prostate Notes ↗
C62.00 Malignant neoplasm of unspecified undescended testis Notes ↗
C62.01 Malignant neoplasm of undescended right testis Notes ↗
C62.02 Malignant neoplasm of undescended left testis Notes ↗
C62.10 Malignant neoplasm of unspecified descended testis Notes ↗
C62.11 Malignant neoplasm of descended right testis Notes ↗
C62.12 Malignant neoplasm of descended left testis Notes ↗
C62.90 Malignant neoplasm of unspecified testis, unspecified whether descended or undescended Notes ↗
C62.91 Malignant neoplasm of right testis, unspecified whether descended or undescended Notes ↗
C62.92 Malignant neoplasm of left testis, unspecified whether descended or undescended Notes ↗
C63.00 Malignant neoplasm of unspecified epididymis Notes ↗
C63.01 Malignant neoplasm of right epididymis Notes ↗
C63.02 Malignant neoplasm of left epididymis Notes ↗
C63.10 Malignant neoplasm of unspecified spermatic cord Notes ↗
C63.11 Malignant neoplasm of right spermatic cord Notes ↗
C63.12 Malignant neoplasm of left spermatic cord Notes ↗
C63.2 Malignant neoplasm of scrotum Notes ↗
C63.7 Malignant neoplasm of other specified male genital organs Notes ↗
C63.8 Malignant neoplasm of overlapping sites of male genital organs Notes ↗
C63.9 Malignant neoplasm of male genital organ, unspecified Notes ↗
C69.00 Malignant neoplasm of unspecified conjunctiva Notes ↗
C69.01 Malignant neoplasm of right conjunctiva Notes ↗
C69.02 Malignant neoplasm of left conjunctiva Notes ↗
C69.10 Malignant neoplasm of unspecified cornea Notes ↗
C69.11 Malignant neoplasm of right cornea Notes ↗
C69.12 Malignant neoplasm of left cornea Notes ↗
C69.20 Malignant neoplasm of unspecified retina Notes ↗
C69.21 Malignant neoplasm of right retina Notes ↗
C69.22 Malignant neoplasm of left retina Notes ↗
C69.30 Malignant neoplasm of unspecified choroid Notes ↗
C69.31 Malignant neoplasm of right choroid Notes ↗
C69.32 Malignant neoplasm of left choroid Notes ↗
C69.40 Malignant neoplasm of unspecified ciliary body Notes ↗
C69.41 Malignant neoplasm of right ciliary body Notes ↗
C69.42 Malignant neoplasm of left ciliary body Notes ↗
C69.50 Malignant neoplasm of unspecified lacrimal gland and duct Notes ↗
C69.51 Malignant neoplasm of right lacrimal gland and duct Notes ↗
C69.52 Malignant neoplasm of left lacrimal gland and duct Notes ↗
C69.60 Malignant neoplasm of unspecified orbit Notes ↗
C69.61 Malignant neoplasm of right orbit Notes ↗
C69.62 Malignant neoplasm of left orbit Notes ↗
C69.80 Malignant neoplasm of overlapping sites of unspecified eye and adnexa Notes ↗
C69.81 Malignant neoplasm of overlapping sites of right eye and adnexa Notes ↗
C69.82 Malignant neoplasm of overlapping sites of left eye and adnexa Notes ↗
C69.90 Malignant neoplasm of unspecified site of unspecified eye Notes ↗
C69.91 Malignant neoplasm of unspecified site of right eye Notes ↗
C69.92 Malignant neoplasm of unspecified site of left eye Notes ↗
C73 Malignant neoplasm of thyroid gland Notes ↗
C75.0 Malignant neoplasm of parathyroid gland Notes ↗
C75.4 Malignant neoplasm of carotid body Notes ↗
C75.5 Malignant neoplasm of aortic body and other paraganglia Notes ↗
C75.8 Malignant neoplasm with pluriglandular involvement, unspecified Notes ↗
C75.9 Malignant neoplasm of endocrine gland, unspecified Notes ↗
C76.0 Malignant neoplasm of head, face and neck Notes ↗
C76.1 Malignant neoplasm of thorax Notes ↗
C76.2 Malignant neoplasm of abdomen Notes ↗
C76.3 Malignant neoplasm of pelvis Notes ↗
C76.40 Malignant neoplasm of unspecified upper limb Notes ↗
C76.41 Malignant neoplasm of right upper limb Notes ↗
C76.42 Malignant neoplasm of left upper limb Notes ↗
C76.50 Malignant neoplasm of unspecified lower limb Notes ↗
C76.51 Malignant neoplasm of right lower limb Notes ↗
C76.52 Malignant neoplasm of left lower limb Notes ↗
C76.8 Malignant neoplasm of other specified ill-defined sites Notes ↗
C80.1 Malignant (primary) neoplasm, unspecified Notes ↗
C80.2 Malignant neoplasm associated with transplanted organ Notes ↗
D03.0 Melanoma in situ of lip Notes ↗
D03.10 Melanoma in situ of unspecified eyelid, including canthus Notes ↗
D03.111 Melanoma in situ of right upper eyelid, including canthus Notes ↗
D03.112 Melanoma in situ of right lower eyelid, including canthus Notes ↗
D03.121 Melanoma in situ of left upper eyelid, including canthus Notes ↗
D03.122 Melanoma in situ of left lower eyelid, including canthus Notes ↗
D03.20 Melanoma in situ of unspecified ear and external auricular canal Notes ↗
D03.21 Melanoma in situ of right ear and external auricular canal Notes ↗
D03.22 Melanoma in situ of left ear and external auricular canal Notes ↗
D03.30 Melanoma in situ of unspecified part of face Notes ↗
D03.39 Melanoma in situ of other parts of face Notes ↗
D03.4 Melanoma in situ of scalp and neck Notes ↗
D03.51 Melanoma in situ of anal skin Notes ↗
D03.52 Melanoma in situ of breast (skin) (soft tissue) Notes ↗
D03.59 Melanoma in situ of other part of trunk Notes ↗
D03.60 Melanoma in situ of unspecified upper limb, including shoulder Notes ↗
D03.61 Melanoma in situ of right upper limb, including shoulder Notes ↗
D03.62 Melanoma in situ of left upper limb, including shoulder Notes ↗
D03.70 Melanoma in situ of unspecified lower limb, including hip Notes ↗
D03.71 Melanoma in situ of right lower limb, including hip Notes ↗
D03.72 Melanoma in situ of left lower limb, including hip Notes ↗
D03.8 Melanoma in situ of other sites Notes ↗
D03.9 Melanoma in situ, unspecified Notes ↗
D18.02 Hemangioma of intracranial structures Notes ↗
D32.0 Benign neoplasm of cerebral meninges Notes ↗
D32.1 Benign neoplasm of spinal meninges Notes ↗
D32.9 Benign neoplasm of meninges, unspecified Notes ↗
D33.0 Benign neoplasm of brain, supratentorial Notes ↗
D33.1 Benign neoplasm of brain, infratentorial Notes ↗
D33.2 Benign neoplasm of brain, unspecified Notes ↗
D33.3 Benign neoplasm of cranial nerves Notes ↗
D33.4 Benign neoplasm of spinal cord Notes ↗
D33.7 Benign neoplasm of other specified parts of central nervous system Notes ↗
D33.9 Benign neoplasm of central nervous system, unspecified Notes ↗
D35.2 Benign neoplasm of pituitary gland Notes ↗
D35.3 Benign neoplasm of craniopharyngeal duct Notes ↗
D35.4 Benign neoplasm of pineal gland Notes ↗
D42.0 Neoplasm of uncertain behavior of cerebral meninges Notes ↗
D42.1 Neoplasm of uncertain behavior of spinal meninges Notes ↗
D42.9 Neoplasm of uncertain behavior of meninges, unspecified Notes ↗
D43.0 Neoplasm of uncertain behavior of brain, supratentorial Notes ↗
D43.1 Neoplasm of uncertain behavior of brain, infratentorial Notes ↗
D43.2 Neoplasm of uncertain behavior of brain, unspecified Notes ↗
D43.3 Neoplasm of uncertain behavior of cranial nerves Notes ↗
D43.4 Neoplasm of uncertain behavior of spinal cord Notes ↗
D43.8 Neoplasm of uncertain behavior of other specified parts of central nervous system Notes ↗
D43.9 Neoplasm of uncertain behavior of central nervous system, unspecified Notes ↗
D44.3 Neoplasm of uncertain behavior of pituitary gland Notes ↗
D44.4 Neoplasm of uncertain behavior of craniopharyngeal duct Notes ↗
D44.5 Neoplasm of uncertain behavior of pineal gland Notes ↗
D44.6 Neoplasm of uncertain behavior of carotid body Notes ↗
D44.7 Neoplasm of uncertain behavior of aortic body and other paraganglia Notes ↗
D45 Polycythemia vera Notes ↗
D47.3 Essential (hemorrhagic) thrombocythemia Notes ↗
D49.6 Neoplasm of unspecified behavior of brain Notes ↗
Q85.00 Neurofibromatosis, unspecified Notes ↗
Q85.01 Neurofibromatosis, type 1 Notes ↗
Q85.02 Neurofibromatosis, type 2 Notes ↗
Q85.03 Schwannomatosis Notes ↗
Q85.09 Other neurofibromatosis Notes ↗
Q85.1 Tuberous sclerosis Notes ↗
Q85.81 PTEN hamartoma tumor syndrome Notes ↗
Q85.82 Other Cowden syndrome Notes ↗
Q85.83 Von Hippel-Lindau syndrome Notes ↗
Q85.89 Other phakomatoses, not elsewhere classified Notes ↗
Q85.9 Phakomatosis, unspecified Notes ↗
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