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V28 HCC 111Community non-dual aged RAF 4.639

Hemophilia, Male

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 111 carries a community non-dual aged RAF of 4.639, and 2 payable ICD-10-CM diagnosis codes map to it.

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

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)

Payable diagnosis codes that map to this category under CMS-HCC V28 PY2026. Open any code for its full description, HCC mapping, and coding guidance.

Frequently asked questions

What is CMS-HCC V28 category 111?

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

What is the RAF weight for HCC 111?

The community non-dual aged relative factor for CMS-HCC V28 category 111 is 4.639. The exact factor varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 Rate Announcement.

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

2 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 111 (Hemophilia, Male) for payment year 2026.

Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.