2027 ICD-10-CM Diagnosis Code C49.5Malignant neoplasm of connective and soft tissue of pelvis
ICD-10-CM Codes›C00–D49›C45-C49›C49
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 21
- Chronic Condition
C49.5 is a billable ICD-10-CM diagnosis code for malignant neoplasm of connective and soft tissue of pelvis. 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, C49.5 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
C49.5 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.
- Malignant neoplasm of soft tissue of buttock
- Malignant neoplasm of soft tissue of pelvis
- Neoplasm of blood vessel of buttock
- Neoplasm of blood vessel of inguinal region
- Neoplasm of blood vessel of pelvis
- Neoplasm of blood vessel of perineum
- Neoplasm of coccygeal body
- Neoplasm of muscle of buttock
- Neoplasm of muscle of hip
- Neoplasm of muscle of inguinal region
- Neoplasm of muscle of pelvis
- Neoplasm of muscle of perineum
- Neoplasm of soft tissues of inguinal region
- Primary angiosarcoma of inguinal region
- Primary angiosarcoma of pelvis
- Primary angiosarcoma of trunk
- Primary leiomyosarcoma of buttock
- Primary leiomyosarcoma of inguinal region
- Primary leiomyosarcoma of pelvis
- Primary leiomyosarcoma of perineum
- Primary liposarcoma of soft tissue of buttock
- Primary liposarcoma of soft tissue of inguinal region
- Primary liposarcoma of soft tissue of limb
- Primary liposarcoma of soft tissue of pelvis
- Primary liposarcoma of soft tissue of perineum
- Primary liposarcoma of soft tissue of trunk
- Primary malignant fibrous histiocytoma of buttock
- Primary malignant fibrous histiocytoma of soft tissue of lower limb
- Primary malignant neoplasm of blood vessel of buttock
- Primary malignant neoplasm of blood vessel of inguinal region
- Primary malignant neoplasm of blood vessel of lower limb
- Primary malignant neoplasm of blood vessel of pelvis
- Primary malignant neoplasm of blood vessel of perineum
- Primary malignant neoplasm of blood vessel of trunk
- Primary malignant neoplasm of coccygeal body
- Primary malignant neoplasm of inguinal region
- Primary malignant neoplasm of muscle of buttock
- Primary malignant neoplasm of muscle of hip
- Primary malignant neoplasm of muscle of inguinal region
- Primary malignant neoplasm of muscle of lower limb
- Primary malignant neoplasm of muscle of pelvis
- Primary malignant neoplasm of muscle of perineum
- Primary malignant neoplasm of muscle of trunk
- Primary malignant neoplasm of paraganglion
- Primary malignant neoplasm of skin of perineum
- Primary malignant neoplasm of soft tissues of buttock
- Primary malignant neoplasm of soft tissues of inguinal region
- Primary malignant neoplasm of soft tissues of pelvis
- Primary malignant neoplasm of soft tissues of perineum
- Primary rhabdomyosarcoma of buttock
- Primary rhabdomyosarcoma of inguinal region
- Primary rhabdomyosarcoma of pelvis
- Primary rhabdomyosarcoma of perineum
- Primary sarcoma of buttock
- Primary sarcoma of inguinal region
- Primary sarcoma of perineum
- Sarcoma of pelvis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to C49.5: 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)
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Malignant neoplasm of buttock
- Malignant neoplasm of groin
- Malignant neoplasm of perineum
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 C49.5, its category, or a range that includes it.
Applicable To 1
These notes mention C49.5.
- Z85.83 Personal history of malignant neoplasm of bone and soft tissue
Excludes1 1
These codes carry an Excludes1 note naming C49.5: 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 C49.5 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. |
|---|---|---|---|---|---|---|
| coccygeal › body or glomus | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › buttock | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › extrarectal | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › gluteal region | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › groin | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › iliopsoas muscle | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › inguinal (canal) (region) | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › ischiorectal fossa | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › nates | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › pararectal | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › para-urethral | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › paravaginal | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › pelvis (floor) | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › perineum | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › perirectal (tissue) | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › periurethral (tissue) | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › presacral | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › rectovaginal septum or wall | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › rectovesical | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › sacrococcygeal region | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| connective tissue NEC › vesicorectal | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
| glomus › coccygeal | C49.5 | C79.89 | – | D21.5 | D48.1 | D49.2 |
Patient EducationClinical
Cancer
Cancer is not just one disease but many diseases. Cancer begins in your cells, which are the building blocks of your body. Usually, your body forms new cells as needed, replacing old cells that die. Sometimes this process goes wrong. New cells grow even when you don't need them, and old cells don't die when they should.
The full article covers:
- What is cancer?
- What are the types of cancer?
- How does cancer develop?
- What are the symptoms of cancer?
- How is cancer diagnosed?
- What are the treatments for cancer?
- Can cancer be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert C49.5 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C49.5Overview
What is the ICD-10 code for malignant neoplasm of connective and soft tissue of pelvis?
The ICD-10-CM code for malignant neoplasm of connective and soft tissue of pelvis is C49.5 (sometimes written as C495). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is C49.5 (Malignant neoplasm of other connective and soft tissue) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malignant neoplasm of connective and soft tissue of pelvis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does C49.5 group to?
When malignant neoplasm of connective and soft tissue of pelvis 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 C49.5 a CC or MCC?
CMS lists C49.5 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 C49.5 be reported with C32.3?
Not as a rule. The Excludes1 note at C49, which applies to C49.5, 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 HCC is C49.5?
C49.5 (malignant neoplasm of connective and soft tissue of pelvis) 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 C49.5 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C49.5 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.
