C67.0
BillableMalignant neoplasm of trigone of bladder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is C67.0 an HCC code?
Yes. C67.0 maps to Colorectal, Bladder, and Other Cancers under the CMS-HCC V28 risk adjustment model (and Colorectal, Bladder, and Other Cancers under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for C67.0
For C67.0 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- 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
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed C67.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
C67.0 is the ICD-10-CM diagnosis code for malignant neoplasm of trigone of bladder. Cancer that develops in the trigone, which is the triangular area at the base of the bladder where the ureters enter. C67.0 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of urinary tract (c64-c68).
Under the CMS-HCC V28 risk adjustment model, C67.0 maps to Colorectal, Bladder, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, C67.0 mapped to the same category but with a base RAF weight of 0.306 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
The trigone is a specific anatomical location; ensure documentation specifies this site. Because C67.0 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for C67.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The trigone is a specific anatomical location; ensure documentation specifies this site
- •This location is clinically significant as it affects urine flow from both kidneys
Clinical Significance
Trigone of the bladder is the triangular region at the base formed by the two ureteral orifices and the internal urethral orifice. Trigonal tumors are clinically significant because of their proximity to both ureteral orifices (risk of obstruction and hydronephrosis) and the bladder neck (risk of urethral involvement). Accurate subsite coding supports treatment planning and surgical approach determination.
Documentation Requirements
- ✓Cystoscopy or pathology report confirming malignancy at the trigone
- ✓Histologic type (urothelial carcinoma in >90% of cases)
- ✓Grade and stage (Ta, T1, T2, etc.)
- ✓Whether muscle-invasive or non-muscle-invasive
- ✓Ureteral orifice involvement or hydronephrosis status
- ✓Treatment plan (transurethral resection, intravesical therapy, cystectomy)
Commonly Confused Codes
- •C67.5 — Bladder neck cancer; the trigone and bladder neck are adjacent but distinct regions
- •C67.6 — Ureteric orifice cancer; the ureteral openings are within the trigone but have their own code
- •C67.9 — Unspecified bladder; use C67.0 when trigone is specifically documented
- •C67.1-C67.4 — Other bladder wall sites; each has specific anatomical boundaries