Skip to content

V28 HCC 111

Hemophilia, Male

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 111 has a source-labeled community non-dual aged reference coefficient of 4.639, and 2 ICD-10-CM diagnosis codes appear in its official mapping.

By the HCC Buddy Coding Team · Reviewed: May 30, 2026
V28 HCC 111Community non-dual aged reference coefficient 4.639

RAF factors

The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.

Community NA: 4.639Community PBA: 11.201Community FBA: 15.539Community ND: 30.706Community PBD: 32.199Community FBD: 31.424Institutional: 6.31

These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.

V28 hierarchy

Supersedes: HCC 112 (this category is counted instead of these when they co-occur).

ICD-10-CM codes that map to HCC 111 (2)

ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

A printable reference for HCC 111: representative mapping rows and MEAT reminders. Free, no card.

Free PDF. No card. Unsubscribe anytime.

Frequently asked questions

What is CMS-HCC V28 category 111?

HCC 111 is "Hemophilia, Male", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 2 ICD-10-CM codes appear in its official mapping.

What reference coefficient is published for HCC 111?

The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 111 is 4.639. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.

How many ICD-10-CM codes map to HCC 111?

2 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 111 (Hemophilia, Male) for payment year 2026.

Related references

Sources

CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.

Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.