2027 ICD-10-CM Diagnosis Code C85.28Mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites

ICD-10-CM Codes›C00–D49›C81-C96›C85

ICD-10-CM C85.28
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

C85.28 is a billable ICD-10-CM diagnosis code for mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 820 through 825, 840 through 842, 974 through 976. 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 148 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Non-Hodgkin lymphoma.

For Medicare Advantage risk adjustment, C85.28 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
C85.28
Billable Status
Yes — Valid for Submission
Code Describes
Mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites
Short Description
Mediastinal (thymic) large B-cell lymphoma, nodes mult site
Parent Code
Mediastinal (thymic) large B-cell lymphoma

Code Classification

ChapterC00–D49Neoplasms
SectionC81-C96Malignant neoplasms of lymphoid, hematopoietic and related tissue
CategoryC85Other specified and unspecified types of non-Hodgkin lymphoma
This CodeC85.28Mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites

Medicare Risk Adjustment (HCC)Billing

C85.28 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Superseded by HCC 17, HCC 18, HCC 19, and HCC 20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 21 — Lymphomas and Other Hematologic Cancers
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.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to C85.28: its own notes plus those printed at C85, block C81-C96, 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.

From C85 Other specified and unspecified types of non-Hodgkin lymphoma applies to 44 codes
  • other specified types of T/NK-cell lymphoma (C86.-)
  • personal history of non-Hodgkin lymphoma (Z85.72)

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.

From Block C81-C96 Malignant neoplasms of lymphoid, hematopoietic and related tissue applies to 533 codes
  • Kaposi's sarcoma of lymph nodes (C46.3)
  • secondary and unspecified neoplasm of lymph nodes (C77.-)
  • secondary neoplasm of bone marrow (C79.52)
  • secondary neoplasm of spleen (C78.89)

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 C85.28, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming C85.28: they are not reported together with it, unless the two conditions are unrelated.

  • C83.3 Diffuse large B-cell lymphoma
    mediastinal (thymic) large B-cell lymphoma (C85.2-) names C85.2-, which includes this code
  • C83.8 Other non-follicular lymphoma
    mediastinal (thymic) large B-cell lymphoma (C85.2-) names C85.2-, which includes this code

Clinical ClassificationClinical

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

CCSR NEO058
Non-Hodgkin lymphoma
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Primary Mediastinal (Thymic) Large B-Cell Lymphoma

    a large b-cell non-hodgkin lymphoma arising in the mediastinum. morphologically it is characterized by a massive diffuse lymphocytic proliferation associated with compartmentalizing fibrosis. response to intensive chemotherapy, with or without radiotherapy, is usually good. (who, 2001)

Patient EducationClinical

Lymphoma

Lymphoma is a cancer of a part of the immune system called the lymph system. There are many types of lymphoma. One type is Hodgkin disease. The rest are called non-Hodgkin lymphomas.

Read the full article at MedlinePlus

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

Convert C85.28 to ICD-9-CMHistory

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

ICD-9-CM
200.78 Large cell lymph multip
Approximate The match is approximate rather than exact.
ICD-9-CM
202.88 Lymphomas NEC mult
Approximate The match is approximate rather than exact.

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 C85.28Overview

Is C85.28 (Mediastinal (thymic) large B-cell lymphoma) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does C85.28 group to?

When mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites is the principal diagnosis on an inpatient stay, it groups to MS-DRG 820, 821, 822, 823, 824, 825, 840, 841, 842, 974, 975, 976, with relative weights from 0.7879 to 6.2454 depending on complications. Higher weights mean higher Medicare reimbursement.

Is C85.28 a CC or MCC?

CMS lists C85.28 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 148 closely related codes in its exclusion list.

Can C85.28 be reported with a code from C86?

Not as a rule. The Excludes1 note at C85, which applies to C85.28, lists "other specified types of T/NK-cell lymphoma (C86.-)". 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 C85.28?

Under the General Equivalence Mappings, mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites converts to ICD-9-CM 200.78 (large cell lymph multip) and 202.88 (lymphomas NEC mult). The mapping is approximate, so confirm the match fits the documentation.

What HCC is C85.28?

C85.28 (mediastinal (thymic) large B-cell lymphoma, lymph nodes of multiple sites) 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 21.

Does C85.28 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, C85.28 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.