2027 ICD-10-CM Diagnosis Code C76.1Malignant neoplasm of thorax
ICD-10-CM Codes›C00–D49›C76-C80›C76
- Billable — Valid for Submission
- Risk Adjusts — HCC 23
- Chronic Condition
C76.1 is a billable ICD-10-CM diagnosis code for malignant neoplasm of thorax. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 180 through 182. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cancer of other sites.
For Medicare Advantage risk adjustment, C76.1 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
C76.1 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.
- Abdominothoracic neuroblastoma
- Malignant melanoma of axilla
- Malignant melanoma of chest wall
- Malignant melanoma of shoulder
- Malignant neoplasm of axilla
- Malignant neoplasm of chest wall
- Malignant neoplasm of thoracic cavity structure
- Malignant neoplasm of thorax
- Primary abdominothoracic neuroblastoma
- Primary adenocarcinoma of chest wall
- Primary malignant neoplasm of axilla
- Primary malignant neoplasm of chest wall
- Primary malignant neoplasm of intrathoracic organs
- Primary neuroblastoma
- Primary rhabdomyosarcoma of intrathoracic organ
- Primary rhabdomyosarcoma of thorax
- Primary sarcoma of axilla
- Primary squamous cell carcinoma of intrathoracic organ
- Primary synovial sarcoma
- Primary synovial sarcoma of intrathoracic organ
- Primary thoracic neuroblastoma
- Primary undifferentiated large cell malignancy of chest wall
- Synovial sarcoma
- Thoracic neuroblastoma
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to C76.1: its own notes plus those printed at C76 and Chapter 2. A note printed at a category, block or chapter applies to every code under it.
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.
- Intrathoracic malignant neoplasm NOS
- Malignant neoplasm of axilla NOS
- Thoracic malignant neoplasm NOS
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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 C76.1, its category, or a range that includes it.
Applicable To 2
These notes mention C76.1.
Excludes1 2
These codes carry an Excludes1 note naming C76.1: they are not reported together with it, unless the two conditions are unrelated.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Malignant Thoracic Neoplasm
a primary or metastatic malignant neoplasm affecting the tissues of the thorax.
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. |
|---|---|---|---|---|---|---|
| axilla, axillary | C76.1 | C79.89 | D09.8 | D36.7 | D48.7 | D49.89 |
| chest (wall) NEC | C76.1 | C79.89 | D09.8 | D36.7 | D48.7 | D49.89 |
| infraclavicular (region) | C76.1 | C79.89 | D04.5 | D36.7 | D48.7 | D49.89 |
| intrathoracic (cavity) (organs) | C76.1 | C79.89 | D09.8 | D15.9 | D48.7 | D49.89 |
| intrathoracic (cavity) (organs) › specified NEC | C76.1 | C79.89 | D09.8 | D15.7 | – | – |
| scapular region | C76.1 | C79.89 | D09.8 | D36.7 | D48.7 | D49.89 |
| thorax, thoracic (cavity) (organs NEC) | C76.1 | C79.89 | D09.8 | D36.7 | D48.7 | D49.89 |
| thorax, thoracic (cavity) (organs NEC) › wall NEC | C76.1 | C79.89 | D09.8 | D36.7 | D48.7 | D49.89 |
Patient EducationClinical
Cancer
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Convert C76.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About C76.1Overview
What is the ICD-10 code for malignant neoplasm of thorax?
The ICD-10-CM code for malignant neoplasm of thorax is C76.1 (sometimes written as C761). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is C76.1 (Malignant neoplasm of other and ill-defined sites) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report malignant neoplasm of thorax on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does C76.1 group to?
When malignant neoplasm of thorax is the principal diagnosis on an inpatient stay, it groups to MS-DRG 181, 180, 182, with relative weights from 0.7436 to 1.7800 depending on complications. Higher weights mean higher Medicare reimbursement.
Can C76.1 be reported with C57.9?
Not as a rule. The Excludes1 note at C76, which applies to C76.1, lists "malignant neoplasm of female genitourinary tract NOS (C57.9)". 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 C76.1?
Under the General Equivalence Mappings, malignant neoplasm of thorax converts to ICD-9-CM 195.1 (malign neopl thorax). The mapping is a direct match.
What HCC is C76.1?
C76.1 (malignant neoplasm of thorax) 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 C76.1 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, C76.1 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.
