In 2015, the United States transitioned to the ICD-10-CM/PCS, a comprehensive updated coding system for medical reimbursement. This transition was part of a larger move toward value-based reimbursement in U.S. health care and required nearly 2 decades of planning. As an unfunded mandate from Congress, it created a substantial financial burden for many groups within the health sector. This article traces the ICD-10 transition using the concept of the corporate governance of health care, attending to the role the state plays in mediating intercapitalist maneuvers. The ICD-10 was not a simple top-down declaration originating in a neutral state. Rather, it was produced and modified through lobbying efforts on the part of various stakeholders who, along with their competitors, would be affected by the transition in differential ways. The health information technology industry, in particular, stood to gain the most from this transition, at the expense of other capitalist players. An examination of the intercapitalist maneuevers behind the ICD-10 transition demonstrates that even when corporate powers govern U.S. health care, the role of the state should not be written off as inconsequential but rather interrogated and analyzed in relation to the corporate interests with which it is entangled.