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C50

Non-Billable (Header)

Malignant neoplasm of breast

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

C50 is the ICD-10-CM diagnosis code for malignant neoplasm of breast. C50 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of breast (c50).

Header codes like C50 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at C50's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for C50 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • connective tissue of breast
  • Paget's disease of breast
  • Paget's disease of nipple

Excludes 1 — Do NOT code together

Use Additional Code

  • code to identify estrogen, and other hormones and factors receptor status (Z17.-)

Child Codes

Code Hierarchy

C50Malignant neoplasm of breast
C50Malignant neoplasm of breast

More on C50

Related condition guides

Referenced in blog posts

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