D26.1
BillableOther benign neoplasm of corpus uteri
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D26.1 an HCC code?
No. D26.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
D26.1 is the ICD-10-CM diagnosis code for other benign neoplasm of corpus uteri. A non-cancerous tumor or growth in the main body of the uterus (womb), excluding the cervix. These growths are not life-threatening but may cause symptoms like abnormal bleeding or pelvic discomfort. D26.1 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neoplasms, except benign neuroendocrine tumors (d10-d36).
D26.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify the specific location is the corpus (body) of the uterus and not the cervix, as cervical neoplasms use different codes (D26.0).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D26.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific location is the corpus (body) of the uterus and not the cervix, as cervical neoplasms use different codes (D26.0)
- •Ensure the neoplasm is documented as benign; if malignant, use C54 codes instead, and confirm whether the patient has had a hysterectomy as this affects code selection