What is ICD-10 code C76.2?

C76.2 is the ICD-10-CM diagnosis code for Malignant neoplasm of abdomen. A malignant (cancerous) tumor located in the abdominal area, but the specific organ or tissue of origin is not further specified. It belongs to the ICD-10-CM chapter for neoplasms (c00-d49). C76.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. C76.2 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. C76.2 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. C76.2 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.

What is the V28 vs V24 difference for C76.2?

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 C76.2, V28 maps to Prostate, Breast, and Other Cancers and Tumors at RAF 0.186 while V24 mapped to Breast, Prostate, and Other Cancers and Tumors at RAF 0.150. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting C76.2?

This code applies when abdominal malignancy is documented but the specific organ (liver, pancreas, stomach, etc.) is unidentified Query the provider and review imaging/pathology to determine the primary organ site for more specific coding Because C76.2 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.

2026 ICD-10-CM C76.2: Malignant neoplasm of abdomen

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Code lookupC76.2Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Neoplasms (C00-D49) / Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80)

C76.2

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

Malignant neoplasm of abdomen

A malignant (cancerous) tumor located in the abdominal area, but the specific organ or tissue of origin is not further specified.

Buddy Insight

Malignant neoplasm of the abdomen (ill-defined site) is used for abdominal malignancies where the specific organ of origin cannot be determined.

CMS-HCC V28

Mapped

HCC 23

Prostate, Breast, and Other C...

RAF 0.186

CMS-HCC V24

Mapped

HCC 12

Breast, Prostate, and Other C...

RAF 0.150

ACA/HHS

Mapped

HCC 12

HHS-HCC 12

Varies by metal level

ESRD/PACE

Mapped

HCC 12

Breast, Prostate, and Other C...

RAF 0.045

RXHCC

Mapped

HCC 22

Cancer, Other Specified Sites

RAF 0.124

Code Book Path

Official

C76Malignant neoplasm of other and ill-defined sites

C76.2Malignant neoplasm of abdomen

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for C76.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for C76.2 in this effective period.

Related Child Codes

Official

C76.0Malignant neoplasm of head, face and neck

C76.1Malignant neoplasm of thorax

C76.3Malignant neoplasm of pelvis

C76.4Malignant neoplasm of upper limb

C76.5Malignant neoplasm of lower limb

Includes

Official

ICD-10-CM does not list Includes notes for C76.2 in this effective period.

Excludes 1

Official

malignant neoplasm of female genitourinary tract NOS (C57.9)
malignant neoplasm of male genitourinary tract NOS (C63.9)
malignant neoplasm of lymphoid, hematopoietic and related tissue (C81-C96)
malignant neoplasm of skin (C44.-)
malignant neoplasm of unspecified site NOS (C80.1)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for C76.2 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for C76.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for C76.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation confirming abdominal malignancy without identifiable organ of origin

Cross-sectional imaging (CT abdomen/pelvis, PET scan) documenting tumor extent

Pathology with immunohistochemistry attempting to identify tissue of origin

Tumor marker results (CEA, CA-125, CA 19-9, AFP)

MEAT Support

HCC Buddy guidance

Documentation confirming abdominal malignancy without identifiable organ of origin

Cross-sectional imaging (CT abdomen/pelvis, PET scan) documenting tumor extent

Pathology with immunohistochemistry attempting to identify tissue of origin

Tumor marker results (CEA, CA-125, CA 19-9, AFP)

Audit Caution

HCC Buddy guidance

Using this code when the primary organ is identifiable (stomach, colon, pancreas, liver, ovary)

Not coding peritoneal carcinomatosis with its specific code when peritoneum is the primary site

Failing to review immunohistochemistry that may identify tissue of origin

Using C76.2 for metastatic disease to the abdomen from a known primary elsewhere

Common Mistakes

HCC Buddy guidance

C48.1-C48.2 — Malignant neoplasm of peritoneum: Use when peritoneal origin is confirmed

C78.6 — Secondary malignant neoplasm of retroperitoneum and peritoneum: Metastatic abdominal disease

C26.9 — Malignant neoplasm of gastrointestinal tract, unspecified: GI origin suspected but site unknown

C80.0 — Disseminated malignant neoplasm: Use for widely disseminated disease

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 C76.2 an HCC code?

Yes. C76.2 (Malignant neoplasm of abdomen) maps to Prostate, Breast, and Other Cancers and Tumors under the CMS-HCC V28 risk adjustment model (and Breast, Prostate, and Other Cancers and Tumors under V24), with a community non-dual aged RAF of 0.186. It is billable for payment year 2026.

Coder answer: C76.2 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: C76.2
Description: Malignant neoplasm of abdomen
HCC (V28): HCC 23 — Prostate, Breast, and Other Cancers and Tumors
RAF: 0.186
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 23, Prostate, Breast, and Other Cancers and Tumors

0.186

V24HCC 12, Breast, Prostate, and Other Cancers and Tumors

0.150

ESRDHCC 12, Breast, Prostate, and Other Cancers and Tumors

0.045

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 C76.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for C76.2

For C76.2 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 C76.2 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

C76.2 is the ICD-10-CM diagnosis code for malignant neoplasm of abdomen. A malignant (cancerous) tumor located in the abdominal area, but the specific organ or tissue of origin is not further specified. C76.2 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering malignant neoplasms of ill-defined, other secondary and unspecified sites (c76-c80).

Under the CMS-HCC V28 risk adjustment model, C76.2 maps to Prostate, Breast, and Other Cancers and Tumors (HCC 23) with a community, non-dual, aged base RAF weight of 0.186. Under the older CMS-HCC V24 model, C76.2 maps to Breast, Prostate, and Other Cancers and Tumors (HCC 12) with a community, non-dual, aged base RAF weight of 0.150. 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 code applies when abdominal malignancy is documented but the specific organ (liver, pancreas, stomach, etc.) is unidentified. Because C76.2 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 C76.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code applies when abdominal malignancy is documented but the specific organ (liver, pancreas, stomach, etc.) is unidentified
•Query the provider and review imaging/pathology to determine the primary organ site for more specific coding

Clinical Significance

Malignant neoplasm of the abdomen (ill-defined site) is used for abdominal malignancies where the specific organ of origin cannot be determined. Abdominal carcinomatosis of unknown primary is a common clinical scenario requiring this code. Extensive workup including imaging, tumor markers, and immunohistochemistry should be documented before using this nonspecific code.

Documentation Requirements

✓Documentation confirming abdominal malignancy without identifiable organ of origin
✓Cross-sectional imaging (CT abdomen/pelvis, PET scan) documenting tumor extent
✓Pathology with immunohistochemistry attempting to identify tissue of origin
✓Tumor marker results (CEA, CA-125, CA 19-9, AFP)
✓Documentation of workup performed to identify the primary site

Commonly Confused Codes

•C48.1-C48.2: Malignant neoplasm of peritoneum: Use when peritoneal origin is confirmed
•C78.6: Secondary malignant neoplasm of retroperitoneum and peritoneum: Metastatic abdominal disease
•C26.9: Malignant neoplasm of gastrointestinal tract, unspecified: GI origin suspected but site unknown
•C80.0: Disseminated malignant neoplasm: Use for widely disseminated disease
•C56.9: Malignant neoplasm of ovary: Ovarian cancer often presents as abdominal carcinomatosis