C50.422: Malignant neoplasm of upper-outer quadrant of left male breast
C50.422, malignant neoplasm of upper-outer quadrant of left male breast, is listed as a covered diagnosis in 17 Medicare billing and coding articles that apply to 103 HCPCS Level II codes, including C8903 (Magnetic resonance imaging with contrast, breast; unilateral), C8905 (Magnetic resonance imaging without contrast followed by…), C8906 (Magnetic resonance imaging with contrast, breast; bilateral). 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 4 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 C50.422 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| C8903 | Magnetic resonance imaging with contrast, breast; unilateral | Special coverage instructions apply | — | 2 |
| C8905 | Magnetic resonance imaging without contrast followed by with contrast, breast; unilateral | Special coverage instructions apply | — | 2 |
| C8906 | Magnetic resonance imaging with contrast, breast; bilateral | Special coverage instructions apply | — | 2 |
| C8908 | Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral | Special coverage instructions apply | — | 2 |
| 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 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | Carrier judgment | — | 1 |
| J3316 | Injection, triptorelin, extended-release, 3.75 mg | Special coverage instructions apply | — | 1 |
| J9218 | Leuprolide acetate, per 1 mg | Special coverage instructions apply | — | 1 |
| J3489 | Injection, zoledronic acid, 1 mg | Carrier judgment | — | 1 |
| J1740 | Injection, ibandronate sodium, 1 mg | Carrier judgment | — | 1 |
| J2430 | Injection, pamidronate disodium, per 30 mg | Special coverage instructions apply | — | 1 |
78 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C50.422
- A52849: Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L33585
- A56448: Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L33950
- 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
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34648
- 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
2 more articles list C50.422.
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 C50 diagnoses (Malignant neoplasm of breast)
- C50.421 — Malignant neoplasm of upper-outer quadrant of right male breast
- C50.429 — Malignant neoplasm of upper-outer quadrant of unspecified male breast
- C50.411 — Malignant neoplasm of upper-outer quadrant of right female breast
- C50.412 — Malignant neoplasm of upper-outer quadrant of left female breast
- C50.419 — Malignant neoplasm of upper-outer quadrant of unspecified female…
- C50.011 — Malignant neoplasm of nipple and areola, right female breast
- C50.012 — Malignant neoplasm of nipple and areola, left female breast
- C50.019 — Malignant neoplasm of nipple and areola, unspecified female breast
- C50.021 — Malignant neoplasm of nipple and areola, right male breast
- C50.022 — Malignant neoplasm of nipple and areola, left male breast
- C50.029 — Malignant neoplasm of nipple and areola, unspecified male breast
- C50.111 — Malignant neoplasm of central portion of right female breast
- C50.112 — Malignant neoplasm of central portion of left female breast
- C50.119 — Malignant neoplasm of central portion of unspecified female breast
- C50.121 — Malignant neoplasm of central portion of right male breast
- C50.122 — Malignant neoplasm of central portion of left male breast
- C50.129 — Malignant neoplasm of central portion of unspecified male breast
- C50.211 — Malignant neoplasm of upper-inner quadrant of right female breast
- C50.212 — Malignant neoplasm of upper-inner quadrant of left female breast
- C50.219 — Malignant neoplasm of upper-inner quadrant of unspecified female…
- C50.221 — Malignant neoplasm of upper-inner quadrant of right male breast
- C50.222 — Malignant neoplasm of upper-inner quadrant of left male breast
- C50.229 — Malignant neoplasm of upper-inner quadrant of unspecified male breast
- C50.311 — Malignant neoplasm of lower-inner quadrant of right female breast
- C50.312 — Malignant neoplasm of lower-inner quadrant of left female breast
- C50.319 — Malignant neoplasm of lower-inner quadrant of unspecified female…
- C50.321 — Malignant neoplasm of lower-inner quadrant of right male breast
- C50.322 — Malignant neoplasm of lower-inner quadrant of left male breast
- C50.329 — Malignant neoplasm of lower-inner quadrant of unspecified male breast
- C50.511 — Malignant neoplasm of lower-outer quadrant of right female breast
Frequently asked questions
Does Medicare cover C50.422 (Malignant neoplasm of upper-outer quadrant of left male…)?
Medicare covers items and services, not diagnoses. 17 Medicare billing and coding articles list C50.422 as a covered diagnosis for 103 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 C50.422?
The Level II codes from the policies most specific to this diagnosis are C8903 (Magnetic resonance imaging with contrast, breast; unilateral, 2 articles); C8905 (Magnetic resonance imaging without contrast followed by…, 2 articles); C8906 (Magnetic resonance imaging with contrast, breast; bilateral, 2 articles); C8908 (Magnetic resonance imaging without contrast followed by…, 2 articles); J9217 (Leuprolide acetate (for depot suspension), 7.5 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with C50.422?
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 C50.422?
A52849 (Billing and Coding: Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography); A56448 (Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography); A59160 (Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs), and 14 more articles.
What is ICD-10-CM code C50.422?
C50.422 is the ICD-10-CM code for malignant neoplasm of upper-outer quadrant of left male breast, in category C50 (Malignant neoplasm of breast), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under C8903
- Watch C8903 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C8903
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.