2027 ICD-10-CM Diagnosis Code C49.22Malignant neoplasm of connective and soft tissue of left lower limb, including hip
ICD-10-CM Codes›C00–D49›C45-C49›C49
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 21
- Chronic Condition
C49.22 is a billable ICD-10-CM diagnosis code for malignant neoplasm of connective and soft tissue of left lower limb, including hip. 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 2 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Sarcoma.
For Medicare Advantage risk adjustment, C49.22 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
C49.22 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.
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.
- Mass of muscle of left lower limb
- Primary angiosarcoma of left hip region
- Primary angiosarcoma of left lower limb
- Primary angiosarcoma of trunk
- Primary leiomyosarcoma of left hip region
- Primary leiomyosarcoma of left lower limb
- Primary liposarcoma of soft tissue of left hip
- Primary liposarcoma of soft tissue of left lower limb
- Primary liposarcoma of soft tissue of limb
- Primary malignant fibrous histiocytoma of soft tissue of hip
- Primary malignant fibrous histiocytoma of soft tissue of left hip
- Primary malignant fibrous histiocytoma of soft tissue of left lower limb
- Primary malignant fibrous histiocytoma of soft tissue of lower limb
- Primary malignant neoplasm of muscle of left lower limb
- Primary malignant neoplasm of muscle of lower limb
- Primary malignant neoplasm of soft tissue of left hip
- Primary malignant neoplasm of soft tissue of left lower limb
- Primary rhabdomyosarcoma of hip
- Primary rhabdomyosarcoma of left hip
- Primary rhabdomyosarcoma of left lower limb
- Primary sarcoma of left lower limb
- Primary sarcoma of soft tissues of left hip
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to C49.22: its own notes plus those printed at C49 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.
- malignant neoplasm of blood vessel
- malignant neoplasm of bursa
- malignant neoplasm of cartilage
- malignant neoplasm of fascia
- malignant neoplasm of fat
- malignant neoplasm of ligament, except uterine
- malignant neoplasm of lymphatic vessel
- malignant neoplasm of muscle
- malignant neoplasm of synovia
- malignant neoplasm of tendon (sheath)
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- Kaposi's sarcoma of soft tissue (C46.1)
- malignant neoplasm of heart (C38.0)
- malignant neoplasm of peripheral nerves and autonomic nervous system (C47.-)
- malignant neoplasm of peritoneum (C48.2)
- malignant neoplasm of retroperitoneum (C48.0)
- malignant neoplasm of uterine ligament (C57.3)
- mesothelioma (C45.-)
Notes
General instructions on how these codes are used.
- 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 C49.22, its category, or a range that includes it.
Applicable To 1
These notes mention C49.22.
- Z85.83 Personal history of malignant neoplasm of bone and soft tissue
Excludes1 1
These codes carry an Excludes1 note naming C49.22: they are not reported together with it, unless the two conditions are unrelated.
- Block C40-C41 Malignant neoplasms of bone and articular cartilagemalignant neoplasm of synovia (C49.-) names C49.-, which includes this code
Code First 1
These codes say to code first a condition named in the note, and C49.22 is one of the conditions named.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Table of NeoplasmsClinical
Anatomical sites in the Table of Neoplasms that reference this code family.
| Site | Malig. Primary | Malig. Secondary | Ca in situ | Benign | Uncertain | Unspec. |
|---|---|---|---|---|---|---|
| aponeurosis › plantar | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › ankle | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › calf | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › extremity › lower | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › foot | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › heel | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › hip | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › knee | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › leg | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › limb NEC › lower | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › popliteal fossa or space | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › thigh | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| connective tissue NEC › toe | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
| fascia [See Also: Neoplasm, connective tissue] › plantar | C49.2 | C79.89 | – | D21.2 | D48.1 | D49.2 |
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Convert C49.22 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C49.22Overview
Is C49.22 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malignant neoplasm of connective and soft tissue of left lower limb, including hip on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does C49.22 group to?
When malignant neoplasm of connective and soft tissue of left lower limb, including hip 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 C49.22 a CC or MCC?
CMS lists C49.22 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 2 closely related codes in its exclusion list.
Can C49.22 be reported with C32.3?
Not as a rule. The Excludes1 note at C49, which applies to C49.22, lists "larynx (C32.3)". 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 is the ICD-9 equivalent of C49.22?
Under the General Equivalence Mappings, malignant neoplasm of connective and soft tissue of left lower limb, including hip converts to ICD-9-CM 171.3 (mal neo soft tissue leg). The mapping is approximate, so confirm the match fits the documentation.
What HCC is C49.22?
C49.22 (malignant neoplasm of connective and soft tissue of left lower limb, including hip) 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 C49.22 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C49.22 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.
