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C54.2 ICD-10-CM Code: Malignant neoplasm of myometrium

C54.2 maps to CMS-HCC V28 23. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupC54.2

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of female genital organs (C51-C58)

C54.2

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Malignant neoplasm of myometrium

Cancer that develops in the myometrium, which is the muscular layer of the uterus. This is a less common type of uterine cancer.

Buddy the Bee presenting code insight

Buddy Insight

Malignant neoplasm of the myometrium represents cancer originating in the muscular wall of the uterus.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 23

Coefficient HCC 23: 0.186 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 012

Code-level coefficient reference

ESRD/PACE

HCC 12

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
C54Malignant neoplasm of corpus uteriC54.2Malignant neoplasm of myometrium

Inclusion Terms

Official

No inclusion terms are included in this display for C54.2. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C54.2. Check the code and parent instructions in the Code Book.

Related Codes

Official
C54.0Malignant neoplasm of isthmus uteriC54.1Malignant neoplasm of endometriumC54.3Malignant neoplasm of fundus uteriC54.8Malignant neoplasm of overlapping sites of corpus uteriC54.9Malignant neoplasm of corpus uteri, unspecified

Includes

Official
  • malignant neoplasm of skin of female genital organsInherited from C51-C58

Excludes 1

Official

No Excludes 1 notes are included in this display for C54.2. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for C54.2. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C54.2. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C54.2. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Specific site confirmed as myometrium (muscular layer)
Histological type (leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma)
Differentiation from endometrial carcinoma invading the myometrium versus primary myometrial tumor
Tumor size and extent

MEAT Support

HCC Buddy guidance
Specific site confirmed as myometrium (muscular layer)
Histological type (leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma)
Differentiation from endometrial carcinoma invading the myometrium versus primary myometrial tumor
Tumor size and extent

Audit Caution

HCC Buddy guidance
Confusing endometrial cancer with myometrial invasion versus primary myometrial malignancy — these are different diagnoses
Coding a benign uterine fibroid (leiomyoma) as a malignant myometrial tumor
Not recognizing that most myometrial malignancies are sarcomas requiring different treatment than endometrial carcinomas
Using this code for endometrial cancer that has merely invaded the myometrium — the primary site remains endometrium (C54.1)

Common Mistakes

HCC Buddy guidance
C54.1 — Malignant neoplasm of endometrium; endometrial cancer may invade myometrium but the primary site is endometrium, not myometrium
D25.1 — Intramural leiomyoma of uterus; benign uterine fibroid — must distinguish from leiomyosarcoma
C54.9 — Corpus uteri, unspecified; less specific when myometrium is identified
C54.8 — Overlapping sites of corpus uteri; use when tumor spans multiple uterine structures

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is C54.2 an HCC code?

Yes. C54.2 (Malignant neoplasm of myometrium) maps to HCC 23, Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.186. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: C54.2 is billable and maps to V28 HCC 23, Prostate, Breast, and Other Cancers and Tumors. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
C54.2
Description
Malignant neoplasm of myometrium
HCC (V28)
HCC 23 — Prostate, Breast, and Other Cancers and Tumors
RAF reference coefficient
0.186
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 23, Prostate, Breast, and Other Cancers and Tumors
0.186
ESRDHCC 12, Breast/Prostate/and Other Cancers and Tumors
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work C54.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C54.2

For C54.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

C54.2 is the ICD-10-CM diagnosis code for malignant neoplasm of myometrium. Cancer that develops in the myometrium, which is the muscular layer of the uterus. This is a less common type of uterine cancer. C54.2 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of female genital organs (c51-c58).

Under the CMS-HCC V28 risk adjustment model, C54.2 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a source-labeled community, non-dual, aged reference coefficient of 0.186. No V24 mapping is shown for C54.2; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Distinguish between myometrial sarcomas and carcinomas, as treatment differs significantly. For C54.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for C54.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Distinguish between myometrial sarcomas and carcinomas, as treatment differs significantly
  • •Ensure documentation specifies myometrium involvement rather than endometrial involvement

Clinical Significance

Malignant neoplasm of the myometrium represents cancer originating in the muscular wall of the uterus. Myometrial malignancies are typically sarcomas (leiomyosarcoma, endometrial stromal sarcoma) rather than carcinomas, making them clinically distinct from the more common endometrial cancers. These tumors tend to be more aggressive with different treatment protocols.

Documentation Requirements

  • ✓Specific site confirmed as myometrium (muscular layer)
  • ✓Histological type (leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma)
  • ✓Differentiation from endometrial carcinoma invading the myometrium versus primary myometrial tumor
  • ✓Tumor size and extent
  • ✓FIGO staging
  • ✓Mitotic rate (critical for distinguishing leiomyosarcoma from leiomyoma)
  • ✓Lymph node and distant metastasis assessment

Commonly Confused Codes

  • •C54.1: Malignant neoplasm of endometrium; endometrial cancer may invade myometrium but the primary site is endometrium, not myometrium
  • •D25.1: Intramural leiomyoma of uterus; benign uterine fibroid: must distinguish from leiomyosarcoma
  • •C54.9: Corpus uteri, unspecified; less specific when myometrium is identified
  • •C54.8: Overlapping sites of corpus uteri; use when tumor spans multiple uterine structures

Child Codes

C54.0Malignant neoplasm of isthmus uteri
HCC 23
C54.1Malignant neoplasm of endometrium
HCC 23
C54.2Malignant neoplasm of myometrium
HCC 23
C54.3Malignant neoplasm of fundus uteri
HCC 23
C54.8Malignant neoplasm of overlapping sites of corpus uteri
HCC 23
C54.9Malignant neoplasm of corpus uteri, unspecified
HCC 23

Code Hierarchy

└C54Malignant neoplasm of corpus uteri└C54.2Malignant neoplasm of myometrium
└C54.2Malignant neoplasm of myometrium

Also searched as

  • C54 2
  • C542

For C54.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

C54.2 maps to CMS-HCC V28 category 23, Prostate, Breast, and Other Cancers and Tumors. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for C54.2. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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Open C54.2 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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