C67.3 maps to CMS-HCC V28 22. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

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Code lookupC67.3

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of urinary tract (C64-C68)

C67.3

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

Malignant neoplasm of anterior wall of bladder

Cancer that starts on the front wall of the bladder, the surface closest to the abdominal wall.

Buddy Insight

Anterior wall bladder cancer involves the front portion of the bladder closest to the pubic symphysis.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 22

Bladder, Colorectal, and Othe...

Coefficient HCC 22: 0.363 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 012

HHS-HCC 012 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 11

Colorectal/Bladder/and Other ...

Code-level coefficient reference

RXHCC

Mapped

HCC 22

Prostate, Breast, Bladder, an...

Code-level coefficient reference

Code Book Path

Official

C67Malignant neoplasm of bladder C67.3Malignant neoplasm of anterior wall of bladder

Inclusion Terms

Official

No inclusion terms are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Excludes 2

Official

No Excludes 2 notes are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Related Codes

Official

C67.0Malignant neoplasm of trigone of bladder C67.1Malignant neoplasm of dome of bladder C67.2Malignant neoplasm of lateral wall of bladder C67.4Malignant neoplasm of posterior wall of bladder C67.5Malignant neoplasm of bladder neck

Includes

Official

No Includes notes are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for C67.3. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Cystoscopy or imaging confirming anterior wall tumor location

Histologic type and grade

Stage — particularly depth of invasion and extension beyond bladder wall

Whether tumor extends into prevesical fat or anterior abdominal wall

MEAT Support

HCC Buddy guidance

Cystoscopy or imaging confirming anterior wall tumor location

Histologic type and grade

Stage — particularly depth of invasion and extension beyond bladder wall

Whether tumor extends into prevesical fat or anterior abdominal wall

Audit Caution

HCC Buddy guidance

Using unspecified bladder cancer when the cystoscopy or imaging specifies the anterior wall

Confusing anterior wall with dome — these are distinct anatomical regions of the bladder

Missing urachal carcinoma (C67.7) which specifically involves the urachus in the anterior/dome region

Not documenting extravesical extension into the prevesical space for staging purposes

Common Mistakes

HCC Buddy guidance

C67.1 — Dome of bladder; the dome is superior, the anterior wall faces forward toward the pubis

C67.2 — Lateral wall; side wall vs. front wall

C67.4 — Posterior wall; opposite wall of the bladder

C67.9 — Unspecified bladder; use C67.3 when anterior wall is documented

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 C67.3 an HCC code?

Yes. C67.3 (Malignant neoplasm of anterior wall of bladder) maps to HCC 22, Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.363. 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: C67.3 is billable and maps to V28 HCC 22, Bladder, Colorectal, and Other Cancers. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: C67.3
Description: Malignant neoplasm of anterior wall of bladder
HCC (V28): HCC 22 — Bladder, Colorectal, and Other Cancers
RAF reference coefficient: 0.363
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 22, Bladder, Colorectal, and Other Cancers

0.363

ESRDHCC 11, Colorectal/Bladder/and Other Cancers

Not separately weighted

RxHCCHCC 22, Prostate, Breast, Bladder, 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 C67.3 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for C67.3

For C67.3, 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

C67.3 is the ICD-10-CM diagnosis code for malignant neoplasm of anterior wall of bladder. Cancer that starts on the front wall of the bladder, the surface closest to the abdominal wall. C67.3 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, C67.3 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a source-labeled community, non-dual, aged reference coefficient of 0.363. 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.

Anterior wall is clinically distinct from other bladder locations. For C67.3, 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 C67.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Anterior wall is clinically distinct from other bladder locations
•Verify documentation clearly specifies anterior location rather than general bladder cancer

Clinical Significance

Anterior wall bladder cancer involves the front portion of the bladder closest to the pubic symphysis. Tumors in this location may extend into the prevesical space (space of Retzius) and can involve the anterior abdominal wall in advanced cases. This subsite is less common than lateral wall or trigone tumors but is surgically significant because of its relationship to the pubic bone and anterior peritoneum.

Documentation Requirements

✓Cystoscopy or imaging confirming anterior wall tumor location
✓Histologic type and grade
✓Stage — particularly depth of invasion and extension beyond bladder wall
✓Whether tumor extends into prevesical fat or anterior abdominal wall
✓Treatment plan
✓Relationship to urachus (urachal carcinoma is a rare subtype found in this location)

Commonly Confused Codes

•C67.1: Dome of bladder; the dome is superior, the anterior wall faces forward toward the pubis
•C67.2: Lateral wall; side wall vs. front wall
•C67.4: Posterior wall; opposite wall of the bladder
•C67.9: Unspecified bladder; use C67.3 when anterior wall is documented
•C67.7: Urachus; urachal carcinoma originates from the anterior dome/wall but has its own code