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FY2027 ICD-10-CM reference

C50.012: Malignant neoplasm of nipple and areola, left female breast

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Malignant neoplasm of nipple and areola, left female breast. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Billable code. Verified against the official FY2027 order file.

CMS-HCC V28

  • HCC 23: Prostate, Breast, and Other Cancers and Tumors · RAF 0.186, Community Non-Dual Aged (CNA)

Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.

CMS-HCC V24

Not used for payment year 2027 Medicare Advantage payment

ESRD

Source verification pending

PACE

Source verification pending

RxHCC

Source verification pending

HHS-HCC

Source verification pending

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Instructional note

Functional activity

Source: C00-D49 (chapter, inherited).

Instructional note

All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.

Source: C00-D49 (chapter, inherited).

Instructional note

Morphology [Histology]

Source: C00-D49 (chapter, inherited).

Instructional note

Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.

Source: C00-D49 (chapter, inherited).

Instructional note

Primary malignant neoplasms overlapping site boundaries

Source: C00-D49 (chapter, inherited).

Instructional note

A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.

Source: C00-D49 (chapter, inherited).

Instructional note

Malignant neoplasm of ectopic tissue

Source: C00-D49 (chapter, inherited).

Instructional note

Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

Source: C00-D49 (chapter, inherited).

Includes

connective tissue of breast

Source: C50 (category, inherited).

Includes

Paget's disease of breast

Source: C50 (category, inherited).

Includes

Paget's disease of nipple

Source: C50 (category, inherited).

Instructional note

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

Source: C50 (category, inherited).

Excludes1

skin of breast (C44.501, C44.511, C44.521, C44.591)

Source: C50 (category, inherited).

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does C50.012 mean in FY2027?

The official ICD-10-CM descriptor is Malignant neoplasm of nipple and areola, left female breast. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is C50.012 billable in FY2027?

The FY2027 order file marks C50.012 as billable. Check the complete Tabular instructions and documentation before assigning it.

Does C50.012 map to an HCC?

In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), C50.012 maps to CMS-HCC V28 HCC 23 (Prostate, Breast, and Other Cancers and Tumors). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. ESRD, RxHCC, PACE and HHS-HCC mappings are still pending verification for FY2027.

Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.

Review the FY2026 April edition