C48.1: Malignant neoplasm of specified parts of peritoneum
C48.1, malignant neoplasm of specified parts of peritoneum, is listed as a covered diagnosis in 13 Medicare billing and coding articles that apply to 86 HCPCS Level II codes, including J9217 (Leuprolide acetate (for depot suspension), 7.5 mg), J1952 (Leuprolide injectable, camcevi, 1 mg), J3315 (Injection, triptorelin pamoate, 3.75 mg). 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 3 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 C48.1 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | Special coverage instructions apply | — | 2 |
| J1952 | Leuprolide injectable, camcevi, 1 mg | Carrier judgment | — | 2 |
| J3315 | Injection, triptorelin pamoate, 3.75 mg | Special coverage instructions apply | — | 2 |
| J1954 | Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg | Carrier judgment | — | 2 |
| J9202 | Goserelin acetate implant, per 3.6 mg | Special coverage instructions apply | — | 2 |
| J1950 | Injection, leuprolide acetate (for depot suspension), per 3.75 mg | Special coverage instructions apply | — | 2 |
| J9219 | Leuprolide acetate implant, 65 mg | Special coverage instructions apply | — | 2 |
| J9225 | Histrelin implant (vantas), 50 mg | Special coverage instructions apply | — | 2 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 3 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 3 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 3 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| J3316 | Injection, triptorelin, extended-release, 3.75 mg | Special coverage instructions apply | — | 1 |
| J9218 | Leuprolide acetate, per 1 mg | Special coverage instructions apply | — | 1 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 2 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| Q5129 | Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg | Carrier judgment | — | 1 |
| Q5126 | Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg | Carrier judgment | — | 1 |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | Carrier judgment | — | 1 |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | Special coverage instructions apply | — | 1 |
61 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C48.1
- A59160: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Palmetto GBA (MAC - Part A, MAC - Part B); 8 Level II codes). LCD with the same title: L39387
- A52453: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Wellpoint Federal (MAC - Part A, MAC - Part B); 10 Level II codes). LCD with the same title: L39387
- A52370: Billing and Coding: Bevacizumab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 8 Level II codes)
- A52450: Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) (Wellpoint Federal (MAC - Part A, MAC - Part B); 2 Level II codes)
- A59350: Billing and Coding: Radiation Therapies (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L39553
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes)
- A52479: Oral Anticancer Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 8 Level II codes). LCD with the same title: L33826
- A56462: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L34356
- A56748: Billing and Coding: White Cell Colony Stimulating Factors (Palmetto GBA (MAC - Part A, MAC - Part B); 16 Level II codes). LCD with the same title: L37176
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
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 C48 diagnoses (Malignant neoplasm of retroperitoneum and peritoneum)
- C48.0 — Malignant neoplasm of retroperitoneum
- C48.2 — Malignant neoplasm of peritoneum, unspecified
- C48.8 — Malignant neoplasm of overlapping sites of retroperitoneum and…
Frequently asked questions
Does Medicare cover C48.1 (Malignant neoplasm of specified parts of peritoneum)?
Medicare covers items and services, not diagnoses. 13 Medicare billing and coding articles list C48.1 as a covered diagnosis for 86 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 C48.1?
The Level II codes from the policies most specific to this diagnosis are J9217 (Leuprolide acetate (for depot suspension), 7.5 mg, 2 articles); J1952 (Leuprolide injectable, camcevi, 1 mg, 2 articles); J3315 (Injection, triptorelin pamoate, 3.75 mg, 2 articles); J1954 (Injection, leuprolide acetate for depot suspension…, 2 articles); J9202 (Goserelin acetate implant, per 3.6 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with C48.1?
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 C48.1?
A59160 (Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs); A52453 (Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs); A52370 (Billing and Coding: Bevacizumab and biosimilars), and 10 more articles.
What is ICD-10-CM code C48.1?
C48.1 is the ICD-10-CM code for malignant neoplasm of specified parts of peritoneum, in category C48 (Malignant neoplasm of retroperitoneum and peritoneum), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J9217
- Watch J9217 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9217
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.