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V28 HCC 115Community non-dual aged RAF 0.565

Specified Immunodeficiencies and White Blood Cell Disorders

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 115 carries a community non-dual aged RAF of 0.565, and 19 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 114 when a more severe category in the same disease group is also present.

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: 0.565Community PBA: 0.302Community FBA: 0.438Community ND: 0.692Community PBD: 0.613Community FBD: 0.498Institutional: 0.691

V28 hierarchy

Trumped by: HCC 114 (a more severe category in the same disease group supersedes this one).

ICD-10-CM codes that map to HCC 115 (19)

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 115?

HCC 115 is "Specified Immunodeficiencies and White Blood Cell Disorders", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 19 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 115?

The community non-dual aged relative factor for CMS-HCC V28 category 115 is 0.565. 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 115?

19 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 115 (Specified Immunodeficiencies and White Blood Cell Disorders) for payment year 2026.

Which categories trump HCC 115 in the V28 hierarchy?

HCC 115 is superseded by HCC 114 (Common Variable and Combined Immunodeficiencies). When a more severe category in the same disease group is documented, it is counted instead of HCC 115.

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