C54.1 — Malignant neoplasm of endometrium
C54.1 is a billable, specific ICD-10-CM code for malignant neoplasm of endometrium. It is valid for submission on a claim.
Other codes that can never be billed with C54.1
These codes carry an Excludes1 note pointing at C54.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading C54.1 alone.
- N85.02Endometrial intraepithelial neoplasia [EIN]
Risk adjustment
C54.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 23 Prostate, Breast, and Other Cancers and Tumors0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
C54.1 is named in 85 Medicare coverage policies — 85 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52370Billing and Coding: Bevacizumab and biosimilars
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52450Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)
- A52479Oral Anticancer Drugs - Policy Article
How C54.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to C54.1.
- Sarcoma›endometrial(stromal)
- Sarcoma›stromal(endometrial)
Related codes at this level
Codes that share C54. If C54.1 is not quite right, the correct code is usually one of these.
Questions about C54.1
- Is C54.1 a billable ICD-10-CM code?
- Yes. C54.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does C54.1 sit in the tabular list?
- Neoplasms (C00-D49), in the block Malignant neoplasms of female genital organs (C51-C58).