2027 ICD-10-CM Diagnosis Code L97.214Non-pressure chronic ulcer of right calf with necrosis of bone

ICD-10-CM Codes›L00–L99›L80-L99›L97

ICD-10-CM L97.214
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

L97.214 is a billable ICD-10-CM diagnosis code for non-pressure chronic ulcer of right calf with necrosis of bone. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 573 through 575, 592 through 594. 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 325 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Aseptic necrosis and osteonecrosis and Non-pressure ulcer of skin.

For Medicare Advantage risk adjustment, L97.214 maps to CMS-HCC Category 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) under the V28 model, adding a risk factor of about 1.078 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
L97.214
Billable Status
Yes — Valid for Submission
Code Describes
Non-pressure chronic ulcer of right calf with necrosis of bone
Short Description
Non-pressure chronic ulcer of right calf w necrosis of bone
Parent Code
L97.21
Non-pressure chronic ulcer of right calf

Code Classification

ChapterL00–L99Diseases of the skin and subcutaneous tissue
SectionL80-L99Other disorders of the skin and subcutaneous tissue
CategoryL97Non-pressure chronic ulcer of lower limb, not elsewhere classified
This CodeL97.214Non-pressure chronic ulcer of right calf with necrosis of bone

Medicare Risk Adjustment (HCC)Billing

L97.214 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 380— Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle
Payment HCC · PY 2027 one of 152 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+1.078
community, non-dual, aged · ranges 0.839–1.422 across segments
Hierarchy
Superseded by HCC 379
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 161
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 161 · ESRD (V21): HCC 161 · ESRD (V24): HCC 161
ESRD V21 weights: 0.119 dialysis, 0.225–0.503 functioning graft · ESRD V24 weights: 0.127 dialysis, 0.243–0.782 functioning graft
Part D (RxHCC)
RxHCC 311 — Chronic Ulcer of Skin, Except Pressure
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 L97.214: its own notes plus those printed at L97 and Chapter 12. 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.

From L97 Non-pressure chronic ulcer of lower limb, not elsewhere classified applies to 168 codes
  • chronic ulcer of skin of lower limb NOS
  • non-healing ulcer of skin
  • non-infected sinus of skin
  • trophic ulcer NOS
  • tropical ulcer NOS
  • ulcer of skin of lower limb NOS

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 L97 Non-pressure chronic ulcer of lower limb, not elsewhere classified applies to 168 codes
  • pressure ulcer (pressure area) (L89.-)
  • skin infections (L00-L08)
  • specific infections classified to A00-B99
From Chapter 12 (L00-L99) Diseases of the skin and subcutaneous tissue applies to 1,001 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • lipomelanotic reticulosis (I89.8)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • viral warts (B07.-)

Code First

The underlying condition named in the note is sequenced before this code.

From L97 Non-pressure chronic ulcer of lower limb, not elsewhere classified applies to 168 codes

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name L97.214, its category, or a range that includes it.

Excludes2 3

These codes carry an Excludes2 note naming L97.214: its condition is not part of those codes, and both may be reported when the patient has both.

  • L89 Pressure ulcer
    non-pressure chronic ulcer of skin (L97.-) names L97.-, which includes this code
  • L98.4 Non-pressure chronic ulcer of skin, not elsewhere classified
    ulcer of lower limb NEC (L97.-) names L97.-, which includes this code
  • L98.A Non-pressure chronic ulcer of upper limb, not elsewhere classified
    ulcer of lower limb NEC (L97.-) names L97.-, which includes this code

Use Additional Code 26

These codes say to use an additional code from the note, and L97.214 is one of the codes named.

  • I70.23 Atherosclerosis of native arteries of right leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.24 Atherosclerosis of native arteries of left leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.26 Atherosclerosis of native arteries of extremities with gangrene
    code to identify the severity of any ulcer (L97.-, L98.49-), if applicable names L97.-, which includes this code
  • I70.33 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.34 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.36 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene
    code to identify the severity of any ulcer (L97.-, L98.49-), if applicable names L97.-, which includes this code
  • I70.43 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.44 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.46 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene
    code to identify the severity of any ulcer (L97.-, L98.49-), if applicable names L97.-, which includes this code
  • I70.53 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.54 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.56 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene
    code to identify the severity of any ulcer (L97.-, L98.49-), if applicable names L97.-, which includes this code
  • I70.63 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.64 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration
    code to identify severity of ulcer (L97.-) names L97.-, which includes this code
  • I70.66 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene
    code to identify the severity of any ulcer (L97.-, L98.49-), if applicable names L97.-, which includes this code

11 more Use Additional Code notes name this code. Browse all Use Additional Code notes.

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

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

CCSR MUS030
Aseptic necrosis and osteonecrosis
Default principal diagnosis: inpatient No · outpatient No
CCSR SKN004
Non-pressure ulcer of skin
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Skin Conditions

Your skin is your body's largest organ. It covers the entire outside of your body. There are many ways that your skin protects your body and helps keep you healthy. For example, it:

The full article covers:

  • What does your skin do?
  • What problems and conditions can affect your skin?
  • How can I keep my skin healthy?

Read the full article at MedlinePlus

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

Convert L97.214 to ICD-9-CMHistory

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

ICD-9-CM
707.12 Ulcer of calf
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 L97.214Overview

What is the ICD-10 code for non-pressure chronic ulcer of right calf with necrosis of bone?

The ICD-10-CM code for non-pressure chronic ulcer of right calf with necrosis of bone is L97.214 (sometimes written as L97214). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is L97.214 (Non-pressure chronic ulcer of right calf) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report non-pressure chronic ulcer of right calf with necrosis of bone on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does L97.214 group to?

When non-pressure chronic ulcer of right calf with necrosis of bone is the principal diagnosis on an inpatient stay, it groups to MS-DRG 592, 573, 574, 575, 593, 594, with relative weights from 0.7347 to 6.3547 depending on complications. Higher weights mean higher Medicare reimbursement.

Is L97.214 a CC or MCC?

CMS lists L97.214 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 325 closely related codes in its exclusion list.

What is coded first with L97.214?

The Code First note at L97, which applies to L97.214, reads: any associated underlying condition, such as: any associated gangrene (I96); atherosclerosis of the lower extremities (I70.23-, I70.24-, I70.33-, I70.34-, I70.43-, I70.44-, I70.53-, I70.54-, I70.63-, I70.64-, I70.73-, I70.74-); chronic venous hypertension (I87.31-, I87.33-); diabetic ulcers (E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621, E13.622); postphlebitic syndrome (I87.01-, I87.03-); and 2 more listed in the Instructional Notes section. When one of these applies, it is sequenced before L97.214.

What HCC is L97.214?

L97.214 (non-pressure chronic ulcer of right calf with necrosis of bone) maps to CMS-HCC Category 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle), commonly written as HCC 380, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 161 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 311.

Does L97.214 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, L97.214 adds a risk adjustment factor of about 1.078 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.839 to 1.422 depending on the payment segment). A more severe related category (HCC 379) supersedes it when both are reported. See the full factor table on the HCC 380 category page.