M67.261 ICD-10-CM Code: Synovial hypertrophy, not elsewhere classified, right lower leg
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of synovium and tendon (M65-M67)
M67.261
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSynovial hypertrophy, not elsewhere classified, right lower leg
Abnormal thickening of the synovial membrane in the right lower leg, not due to a specific named condition.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M67.261 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M67.261 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M67.261 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M67.261 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M67.261 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M67.261 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M67.261 in this effective period.
Buddy Documentation Tip
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 M67.261 an HCC code?
No. M67.261 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- M67.261
- Description
- Synovial hypertrophy, not elsewhere classified, right lower leg
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
M67.261 is the ICD-10-CM diagnosis code for synovial hypertrophy, not elsewhere classified, right lower leg. Abnormal thickening of the synovial membrane in the right lower leg, not due to a specific named condition. M67.261 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of synovium and tendon (m65-m67).
M67.261 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.
Confirm right lower leg is documented; lower leg typically refers to the area below the knee.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M67.261 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm right lower leg is documented; lower leg typically refers to the area below the knee
- •Verify this is not secondary to another joint disorder that would require a more specific diagnosis code