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D30.4

Billable

Benign neoplasm of urethra

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is D30.4 an HCC code?

No. D30.4 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

D30.4 is the ICD-10-CM diagnosis code for benign neoplasm of urethra. A non-cancerous tumor in the urethra, the tube through which urine exits the body. D30.4 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neoplasms, except benign neuroendocrine tumors (d10-d36).

D30.4 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.

Urethra tumors are relatively rare; ensure documentation confirms urethral location.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D30.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Urethra tumors are relatively rare; ensure documentation confirms urethral location
  • May be associated with urinary obstruction or hematuria symptoms

Excludes 1 — Do NOT code together

  • benign neoplasm of urethral orifice of bladder (D30.3)

Code Hierarchy

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