2027 ICD-10-CM Diagnosis Code C75.4Malignant neoplasm of carotid body
ICD-10-CM Codes›C00–D49›C73-C75›C75
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 23
- Chronic Condition
C75.4 is a billable ICD-10-CM diagnosis code for malignant neoplasm of carotid body. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 54 through 55. 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 3 closely related codes. Coders also document this condition as adenocarcinoma of carotid body. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Endocrine system cancers - all other types.
For Medicare Advantage risk adjustment, C75.4 maps to CMS-HCC Category 23 (Prostate, Breast, and Other Cancers and Tumors) under the V28 model, adding a risk factor of about 0.186 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
C75.4 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.
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.
- Adenocarcinoma of carotid body
- Adenocarcinoma of paraganglia
- Malignant neoplasm of carotid body
- Neoplasm of carotid body
- Primary adenocarcinoma of carotid body
- Primary adenocarcinoma of paraganglia
- Primary malignant neoplasm of carotid body
- Primary malignant neoplasm of paraganglion
- Primary malignant paraganglioma of carotid body
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to C75.4: its own notes plus those printed at C75 and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- malignant carcinoid tumors (C7A.0-)
- malignant neoplasm of adrenal gland (C74.-)
- malignant neoplasm of endocrine pancreas (C25.4)
- malignant neoplasm of islets of Langerhans (C25.4)
- malignant neoplasm of ovary (C56.-)
- malignant neoplasm of testis (C62.-)
- malignant neoplasm of thymus (C37)
- malignant neoplasm of thyroid gland (C73)
- malignant neuroendocrine tumors (C7A.-)
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 C75.4, its category, or a range that includes it.
Applicable To 2
These notes mention C75.4.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Metastatic Carotid Body Paraganglioma
a carotid body paraganglioma that metastasizes to other anatomic sites.
Table of NeoplasmsClinical
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 C75.4 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C75.4Overview
What is the ICD-10 code for malignant neoplasm of carotid body?
The ICD-10-CM code for malignant neoplasm of carotid body is C75.4 (sometimes written as C754). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is C75.4 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malignant neoplasm of carotid body on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does C75.4 group to?
When malignant neoplasm of carotid body is the principal diagnosis on an inpatient stay, it groups to MS-DRG 55, 54, with relative weights from 1.0291 to 1.5197 depending on complications. Higher weights mean higher Medicare reimbursement.
Is C75.4 a CC or MCC?
CMS lists C75.4 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 3 closely related codes in its exclusion list.
Can C75.4 be reported with a code from C7A.0?
Not as a rule. The Excludes1 note at C75, which applies to C75.4, lists "malignant carcinoid tumors (C7A.0-)". 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 C75.4?
C75.4 (malignant neoplasm of carotid body) maps to CMS-HCC Category 23 (Prostate, Breast, and Other Cancers and Tumors), commonly written as HCC 23, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 12 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 C75.4 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C75.4 adds a risk adjustment factor of about 0.186 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.186 to 0.237 depending on the payment segment). A more severe related category (HCC 17, HCC 18, HCC 19, HCC 20, HCC 21, and HCC 22) supersedes it when both are reported. See the full factor table on the HCC 23 category page.
