D35.5
BillableBenign neoplasm of carotid body
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is D35.5 an HCC code?
No. D35.5 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
D35.5 is the ICD-10-CM diagnosis code for benign neoplasm of carotid body. A noncancerous tumor of the carotid body, a small sensory organ located in the neck near the carotid artery. D35.5 sits in the ICD-10-CM chapter for neoplasms (c00-d49), within the section covering benign neoplasms, except benign neuroendocrine tumors (d10-d36).
D35.5 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.
Carotid body tumors are rare vascular tumors; confirm benign status and document location (right vs. left).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for D35.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Carotid body tumors are rare vascular tumors; confirm benign status and document location (right vs. left)
- •These tumors may be associated with familial paraganglioma syndrome; note any family history