What is ICD-10 code C67.9?

C67.9 is the ICD-10-CM diagnosis code for Malignant neoplasm of bladder, unspecified. Bladder cancer where the specific location within the bladder has not been identified or documented. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C67.9 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C67.9 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. C67.9 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. C67.9 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does C67.9 map to under V28?

C67.9 maps to CMS-HCC V28 22 (Bladder, Colorectal, and Other Cancers). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does C67.9 pay in RAF?

C67.9 carries a community, non-dual, aged (CNA) RAF weight of 0.363 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for C67.9?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For C67.9, V28 maps to Bladder, Colorectal, and Other Cancers at RAF 0.363 while V24 mapped to Colorectal, Bladder, and Other Cancers at RAF 0.307. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports C67.9?

This is a default code; query the provider for more specific bladder site information when possible Review imaging and pathology reports to determine if a more specific C67 code can be assigned Because C67.9 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM C67.9: Malignant neoplasm

C67.9 maps to CMS-HCC V28 22 (RAF 0.363). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

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

Code lookupC67.9Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

C67.9

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

Malignant neoplasm of bladder, unspecified

Bladder cancer where the specific location within the bladder has not been identified or documented.

Buddy Insight

This unspecified bladder cancer code indicates a confirmed malignancy where the specific anatomical site within the bladder has not been determined or documented.

CMS-HCC V28

Mapped

HCC 22

Bladder, Colorectal, and Othe...

RAF 0.363

CMS-HCC V24

Mapped

HCC 11

Colorectal, Bladder, and Othe...

RAF 0.307

ACA/HHS

Mapped

HCC 12

HHS-HCC 12

Varies by metal level

ESRD/PACE

Mapped

HCC 11

Colorectal, Bladder, and Othe...

RAF 0.059

RXHCC

Mapped

HCC 22

Cancer, Other Specified Sites

RAF 0.124

Code Book Path

Official

C67Malignant neoplasm of bladder

C67.9Malignant neoplasm of bladder, unspecified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C67.9 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C67.9 in this effective period.

Related Child Codes

Official

C67.0Malignant neoplasm of trigone of bladder

C67.1Malignant neoplasm of dome of bladder

C67.2Malignant neoplasm of lateral wall of bladder

C67.3Malignant neoplasm of anterior wall of bladder

C67.4Malignant neoplasm of posterior wall of bladder

Includes

Official

ICD-10-CM does not list Includes notes for C67.9 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for C67.9 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C67.9 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C67.9 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C67.9 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Pathology confirming malignant neoplasm of the bladder

Evidence that more specific site information was sought but unavailable

Current treatment status and clinical stage

Histological type and grade from biopsy

MEAT Support

HCC Buddy guidance

Pathology confirming malignant neoplasm of the bladder

Evidence that more specific site information was sought but unavailable

Current treatment status and clinical stage

Histological type and grade from biopsy

Audit Caution

HCC Buddy guidance

Defaulting to C67.9 without reviewing available cystoscopy, operative, or imaging reports that may specify the site

Using this code for carcinoma in situ of the bladder, which has its own code (D09.0)

Failing to distinguish between active bladder cancer and history of bladder cancer (Z85.51)

Not querying the provider when documentation simply states 'bladder cancer' without anatomical detail

Common Mistakes

HCC Buddy guidance

C67.0-C67.8 — Specific bladder site codes: always query for specificity before using C67.9; cystoscopy reports almost always identify the site

D49.4 — Neoplasm of unspecified behavior, bladder: do not use when malignancy is confirmed

Z85.51 — Personal history of bladder cancer: use when cancer is no longer present and patient is in surveillance

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 C67.9 an HCC code?

Yes. C67.9 (Malignant neoplasm of bladder, unspecified) maps to Bladder, Colorectal, and Other Cancers under the CMS-HCC V28 risk adjustment model (and Colorectal, Bladder, and Other Cancers under V24), with a community non-dual aged RAF of 0.363. It is billable for payment year 2026.

Coder answer: C67.9 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: C67.9
Description: Malignant neoplasm of bladder, unspecified
HCC (V28): HCC 22 — Bladder, Colorectal, and Other Cancers
RAF: 0.363
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 22, Bladder, Colorectal, and Other Cancers

0.363

V24HCC 11, Colorectal, Bladder, and Other Cancers

0.307

ESRDHCC 11, Colorectal, Bladder, and Other Cancers

0.059

RxHCCHCC 22, Cancer, Other Specified Sites

0.124

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work C67.9 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C67.9

For C67.9 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 C67.9 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

C67.9 is the ICD-10-CM diagnosis code for malignant neoplasm of bladder, unspecified. Bladder cancer where the specific location within the bladder has not been identified or documented. C67.9 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, C67.9 maps to Bladder, Colorectal, and Other Cancers (HCC 22) with a community, non-dual, aged base RAF weight of 0.363. Under the older CMS-HCC V24 model, C67.9 maps to Colorectal, Bladder, and Other Cancers (HCC 11) with a community, non-dual, aged base RAF weight of 0.307. 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.

This is a default code; query the provider for more specific bladder site information when possible. Because C67.9 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 C67.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a default code; query the provider for more specific bladder site information when possible
•Review imaging and pathology reports to determine if a more specific C67 code can be assigned

Clinical Significance

This unspecified bladder cancer code indicates a confirmed malignancy where the specific anatomical site within the bladder has not been determined or documented. While it still captures the cancer diagnosis for risk adjustment, it represents a missed opportunity for clinical precision and may signal incomplete documentation that could affect treatment planning.

Documentation Requirements

✓Pathology confirming malignant neoplasm of the bladder
✓Evidence that more specific site information was sought but unavailable
✓Current treatment status and clinical stage
✓Histological type and grade from biopsy
✓Provider query documented if cystoscopy or imaging is available but site not specified in diagnosis

Commonly Confused Codes

•C67.0-C67.8: Specific bladder site codes: always query for specificity before using C67.9; cystoscopy reports almost always identify the site
•D49.4: Neoplasm of unspecified behavior, bladder: do not use when malignancy is confirmed
•Z85.51: Personal history of bladder cancer: use when cancer is no longer present and patient is in surveillance