C26.0: Malignant neoplasm of intestinal tract, part unspecified

C26.0, malignant neoplasm of intestinal tract, part unspecified, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 58 HCPCS Level II codes, including J2353 (Injection, octreotide, depot form for intramuscular…), Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with C26.0 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J2353Injection, octreotide, depot form for intramuscular injection, 1 mgCarrier judgment—1
Q0512Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day periodSpecial coverage instructions apply—2
Q0511Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day periodSpecial coverage instructions apply—2
J8999Prescription drug, oral, chemotherapeutic, nosSpecial coverage instructions apply—1
J8530Cyclophosphamide; oral, 25 mgSpecial coverage instructions apply—1
J8597Antiemetic drug, oral, not otherwise specifiedSpecial coverage instructions apply—1
J8610Methotrexate; oral, 2.5 mgSpecial coverage instructions apply—1
J8498Antiemetic drug, rectal/suppository, not otherwise specifiedSpecial coverage instructions apply—1
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)Special coverage instructions apply—1
J0885Injection, epoetin alfa, (for non-esrd use), 1000 unitsSpecial coverage instructions apply—1
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsSpecial coverage instructions apply—1
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)Special coverage instructions apply—1
Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 unitsSpecial coverage instructions apply—1
J0890Injection, peginesatide, 0.1 mg (for esrd on dialysis)Carrier judgment—1
Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)Special coverage instructions apply—1
Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgramSpecial coverage instructions apply—1
Q5125Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgramCarrier judgment—1
Q5101Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgramSpecial coverage instructions apply—1
J1442Injection, filgrastim (g-csf), excludes biosimilars, 1 microgramSpecial coverage instructions apply—1
J1449Injection, eflapegrastim-xnst, 0.1 mgCarrier judgment—1
J1447Injection, tbo-filgrastim, 1 microgramSpecial coverage instructions apply—1
Q5108Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mgCarrier judgment—1
Q5111Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mgCarrier judgment—1
Q5127Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mgCarrier judgment—1
J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mgCarrier judgment—1

33 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing C26.0

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other C26 diagnoses (Malignant neoplasm of other and ill-defined digestive organs)

Frequently asked questions

Does Medicare cover C26.0 (Malignant neoplasm of intestinal tract, part unspecified)?

Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list C26.0 as a covered diagnosis for 58 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 C26.0?

The Level II codes from the policies most specific to this diagnosis are J2353 (Injection, octreotide, depot form for intramuscular…, 1 article); Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles); Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles); J8999 (Prescription drug, oral, chemotherapeutic, nos, 1 article); J8530 (Cyclophosphamide; oral, 25 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C26.0?

Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.

Which Medicare policy articles list C26.0?

A56531 (Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)); A52479 (Oral Anticancer Drugs - Policy Article); A56462 (Billing and Coding: Erythropoiesis Stimulating Agents (ESA)), and 3 more articles.

What is ICD-10-CM code C26.0?

C26.0 is the ICD-10-CM code for malignant neoplasm of intestinal tract, part unspecified, in category C26 (Malignant neoplasm of other and ill-defined digestive organs), chapter 2: Neoplasms.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 2: Neoplasms · All diagnoses · HCPCS lookup