2027 ICD-10-CM Diagnosis Code C41.4Malignant neoplasm of pelvic bones, sacrum and coccyx

ICD-10-CM Codes›C00–D49›C40-C41›C41

ICD-10-CM C41.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

C41.4 is a billable ICD-10-CM diagnosis code for malignant neoplasm of pelvic bones, sacrum and coccyx. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 542 through 544. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 9 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Bone cancer.

For Medicare Advantage risk adjustment, C41.4 maps to CMS-HCC Category 21 (Lymphoma and Other Cancers) under the V28 model, adding a risk factor of about 0.671 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
C41.4
Billable Status
Yes — Valid for Submission
Code Describes
Malignant neoplasm of pelvic bones, sacrum and coccyx
Short Description
Malignant neoplasm of pelvic bones, sacrum and coccyx
Same as the full description in the CMS dataset.
Parent Code
C41
Malignant neoplasm of bone and articular cartilage of other and unspecified sites

Code Classification

ChapterC00–D49Neoplasms
SectionC40-C41Malignant neoplasms of bone and articular cartilage
CategoryC41Malignant neoplasm of bone and articular cartilage of other and unspecified sites
This CodeC41.4Malignant neoplasm of pelvic bones, sacrum and coccyx

Medicare Risk Adjustment (HCC)Billing

C41.4 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 21— Lymphoma and Other Cancers
Payment HCC · PY 2027 one of 463 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.671
community, non-dual, aged · ranges 0.493–0.739 across segments
Hierarchy
Superseded by HCC 17, HCC 18, HCC 19, and HCC 20
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 10
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 10 · ESRD (V21): HCC 10 · ESRD (V24): HCC 10
ESRD V21 weights: 0.136 dialysis, 0.451–0.668 functioning graft · ESRD V24 weights: 0.111 dialysis, 0.467–0.780 functioning graft
Part D (RxHCC)
RxHCC 22 — Prostate, Breast, Bladder, and Other Cancers and Tumors
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Carcinoma of pelvic bones, sacrum and coccyx
  • Chondrosarcoma of bone of pelvic wall
  • Chordoma of coccyx
  • Chordoma of pelvis
  • Chordoma of sacrum
  • Chordoma of vertebral column
  • Ewing sarcoma of bone of pelvis
  • Malignant neoplasm of coccygeal vertebra
  • Malignant neoplasm of pelvic bones, sacrum and coccyx
  • Malignant neoplasm of sacral vertebra
  • Malignant neoplasm of vertebra
  • Malignant sacral teratoma
  • Malignant teratoma
  • Neoplasm of bone of sacrum
  • Neoplasm of coccyx
  • Neoplasm of ilium
  • Neoplasm of ischium
  • Neoplasm of pubis
  • Primary carcinoma of pelvic bones, sacrum and coccyx
  • Primary chondrosarcoma of articular cartilage
  • Primary chondrosarcoma of articular cartilage of limb
  • Primary chondrosarcoma of articular cartilage of pelvis
  • Primary chondrosarcoma of bone of pelvis
  • Primary Ewing sarcoma of articular cartilage of limb
  • Primary Ewing sarcoma of articular cartilage of pelvis
  • Primary Ewing sarcoma of bone of pelvis
  • Primary malignant neoplasm of coccyx
  • Primary malignant neoplasm of ilium
  • Primary malignant neoplasm of ischium
  • Primary malignant neoplasm of pelvic bones, sacrum and coccyx
  • Primary malignant neoplasm of pubis
  • Primary malignant neoplasm of sacrococcygeal region
  • Primary malignant neoplasm of sacrum
  • Primary osteosarcoma of articular cartilage of limb
  • Primary osteosarcoma of articular cartilage of lower limb
  • Primary osteosarcoma of articular cartilage of pelvis
  • Primary osteosarcoma of pelvis
  • Sacrococcygeal teratoma
  • Sarcoma of bone of pelvis
  • Sarcoma of coccyx
  • Sarcoma of sacrum

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to C41.4: its own notes plus those printed at C41, block C40-C41, and Chapter 2. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Block C40-C41 Malignant neoplasms of bone and articular cartilage applies to 24 codes
  • malignant neoplasm of cartilage (articular) (joint)
  • malignant neoplasm of periosteum

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From C41 Malignant neoplasm of bone and articular cartilage of other and unspecified sites applies to 6 codes
  • malignant neoplasm of bones of limbs (C40.-)
  • malignant neoplasm of cartilage of ear (C49.0)
  • malignant neoplasm of cartilage of eyelid (C49.0)
  • malignant neoplasm of cartilage of larynx (C32.3)
  • malignant neoplasm of cartilage of limbs (C40.-)
  • malignant neoplasm of cartilage of nose (C30.0)
From Block C40-C41 Malignant neoplasms of bone and articular cartilage applies to 24 codes
  • malignant neoplasm of bone marrow NOS (C96.9)
  • malignant neoplasm of synovia (C49.-)

Notes

General instructions on how these codes are used.

From Chapter 2 (C00-D49) Neoplasms applies to 1,730 codes
  • Functional activity
  • All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
  • Morphology [Histology]
  • Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
  • Primary malignant neoplasms overlapping site boundaries
  • A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
  • Malignant neoplasm of ectopic tissue
  • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name C41.4, its category, or a range that includes it.

Applicable To 1

These notes mention C41.4.

  • Z85.83 Personal history of malignant neoplasm of bone and soft tissue
    Conditions classifiable to C40-C41; C45-C49 names C40-C41, which includes this code

Excludes1 2

These codes carry an Excludes1 note naming C41.4: they are not reported together with it, unless the two conditions are unrelated.

  • C41.2 Malignant neoplasm of vertebral column
    malignant neoplasm of sacrum and coccyx (C41.4)
  • C49 Malignant neoplasm of other connective and soft tissue
    articular (C40-C41) names C40-C41, which includes this code

Code First 1

These codes say to code first a condition named in the note, and C41.4 is one of the conditions named.

  • M90.6 Osteitis deformans in neoplastic diseases
    the neoplasm (C40.-, C41.-) names C41.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NEO023
Bone cancer
Default principal diagnosis: inpatient Yes · outpatient Yes

Table of NeoplasmsClinical

Anatomical sites in the Table of Neoplasms that reference this code family.

SiteMalig.
Primary		Malig.
Secondary		Ca
in situ		BenignUncertainUnspec.
bone (periosteum) › acetabulumC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › coccygeal vertebraC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › coccyxC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › hipC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › iliumC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › innominateC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › ischiumC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › pelvicC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › pubicC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › sacral vertebraC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › sacrumC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › spine, spinal (column) › coccyxC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › spine, spinal (column) › sacrumC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › vertebra (column) › coccyxC41.4C79.51–D16.8D48.0D49.2
bone (periosteum) › vertebra (column) › sacrumC41.4C79.51–D16.8D48.0D49.2
coccygeal › vertebraC41.4C79.51–D16.8D48.0D49.2
coccyxC41.4C79.51–D16.8D48.0D49.2
iliumC41.4C79.51–D16.8D48.0D49.2
ischiumC41.4C79.51–D16.8D48.0D49.2
pelvis, pelvic › boneC41.4C79.51–D16.8D48.0D49.2
pubic boneC41.4C79.51–D16.8D48.0D49.2
sacrococcyx, sacrococcygealC41.4C79.51–D16.8D48.0D49.2
sacrum, sacral (vertebra)C41.4C79.51–D16.8D48.0D49.2
spine, spinal (column) › coccyxC41.4C79.51–D16.8D48.0D49.2
spine, spinal (column) › sacrumC41.4C79.51–D16.8D48.0D49.2
symphysis pubisC41.4C79.51–D16.8D48.0D49.2
vertebra (column) › coccyxC41.4C79.51–D16.8D48.0D49.2
vertebra (column) › sacrumC41.4C79.51–D16.8D48.0D49.2

Patient EducationClinical

Bone Cancer

Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another part of the body is more common.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert C41.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
170.6 Mal neo pelvic girdle
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About C41.4Overview

What is the ICD-10 code for malignant neoplasm of pelvic bones, sacrum and coccyx?

The ICD-10-CM code for malignant neoplasm of pelvic bones, sacrum and coccyx is C41.4 (sometimes written as C414). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is C41.4 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report malignant neoplasm of pelvic bones, sacrum and coccyx on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does C41.4 group to?

When malignant neoplasm of pelvic bones, sacrum and coccyx is the principal diagnosis on an inpatient stay, it groups to MS-DRG 543, 544, 542, with relative weights from 0.7404 to 1.7208 depending on complications. Higher weights mean higher Medicare reimbursement.

Is C41.4 a CC or MCC?

CMS lists C41.4 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 9 closely related codes in its exclusion list.

Can C41.4 be reported with a code from C40?

Not as a rule. The Excludes1 note at C41, which applies to C41.4, lists "malignant neoplasm of bones of limbs (C40.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is C41.4?

C41.4 (malignant neoplasm of pelvic bones, sacrum and coccyx) maps to CMS-HCC Category 21 (Lymphoma and Other Cancers), commonly written as HCC 21, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 10 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 22.

Does C41.4 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, C41.4 adds a risk adjustment factor of about 0.671 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.493 to 0.739 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, and HCC 20) supersedes it when both are reported. See the full factor table on the HCC 21 category page.