Z41.1 ICD-10-CM Code: Encounter for cosmetic surgery
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Encounters for other specific health care (Z40-Z53)
Z41.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEncounter for cosmetic surgery
A visit for elective cosmetic or aesthetic surgery to improve appearance, such as facelifts, liposuction, or breast augmentation.
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
Official- Encounter for cosmetic breast implant
- Encounter for cosmetic procedure
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z41.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z41.1 in this effective period.
Excludes 1
Official- encounter for plastic and reconstructive surgery following medical procedure or healed injury (Z42.-)
- encounter for post-mastectomy breast implantation (Z42.1)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z41.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z41.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z41.1 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 Z41.1 an HCC code?
No. Z41.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Z41.1
- Description
- Encounter for cosmetic surgery
- 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
Z41.1 is the ICD-10-CM diagnosis code for encounter for cosmetic surgery. A visit for elective cosmetic or aesthetic surgery to improve appearance, such as facelifts, liposuction, or breast augmentation. Z41.1 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering encounters for other specific health care (z40-z53).
Z41.1 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.
Cosmetic procedures are typically not covered by insurance; verify medical necessity vs. purely cosmetic intent.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z41.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Cosmetic procedures are typically not covered by insurance; verify medical necessity vs. purely cosmetic intent
- •Document whether the procedure is reconstructive (covered) or purely cosmetic (not covered)