Dementia, Mild or Unspecified
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 127 carries a community non-dual aged RAF of 0.341, and 65 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 125, HCC 126 when a more severe category in the same disease group is also present.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.
V28 hierarchy
Trumped by: HCC 125, HCC 126 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 127 (65)
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.
- A81.00Creutzfeldt-Jakob disease, unspecified
- A81.01Variant Creutzfeldt-Jakob disease
- A81.09Other Creutzfeldt-Jakob disease
- A81.1Subacute sclerosing panencephalitis
- A81.2Progressive multifocal leukoencephalopathy
- A81.81Kuru
- A81.82Gerstmann-Straussler-Scheinker syndrome
- A81.83Fatal familial insomnia
- A81.89Other atypical virus infections of central nervous system
- A81.9Atypical virus infection of central nervous system, unspecified
- F01.50Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F01.511Vascular dementia, unspecified severity, with agitation
- F01.518Vascular dementia, unspecified severity, with other behavioral disturbance
- F01.52Vascular dementia, unspecified severity, with psychotic disturbance
- F01.53Vascular dementia, unspecified severity, with mood disturbance
- F01.54Vascular dementia, unspecified severity, with anxiety
- F01.A0Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F01.A11Vascular dementia, mild, with agitation
- F01.A18Vascular dementia, mild, with other behavioral disturbance
- F01.A2Vascular dementia, mild, with psychotic disturbance
- F01.A3Vascular dementia, mild, with mood disturbance
- F01.A4Vascular dementia, mild, with anxiety
- F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F02.811Dementia in other diseases classified elsewhere, unspecified severity, with agitation
- F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
- F02.82Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance
- F02.83Dementia in other diseases classified elsewhere, unspecified severity, with mood disturbance
- F02.84Dementia in other diseases classified elsewhere, unspecified severity, with anxiety
- F02.A0Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F02.A11Dementia in other diseases classified elsewhere, mild, with agitation
- F02.A18Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance
- F02.A2Dementia in other diseases classified elsewhere, mild, with psychotic disturbance
- F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance
- F02.A4Dementia in other diseases classified elsewhere, mild, with anxiety
- F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.911Unspecified dementia, unspecified severity, with agitation
- F03.918Unspecified dementia, unspecified severity, with other behavioral disturbance
- F03.92Unspecified dementia, unspecified severity, with psychotic disturbance
- F03.93Unspecified dementia, unspecified severity, with mood disturbance
- F03.94Unspecified dementia, unspecified severity, with anxiety
- F03.A0Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
- F03.A11Unspecified dementia, mild, with agitation
- F03.A18Unspecified dementia, mild, with other behavioral disturbance
- F03.A2Unspecified dementia, mild, with psychotic disturbance
- F03.A3Unspecified dementia, mild, with mood disturbance
- F03.A4Unspecified dementia, mild, with anxiety
- G30.0Alzheimer's disease with early onset
- G30.1Alzheimer's disease with late onset
- G30.8Other Alzheimer's disease
- G30.9Alzheimer's disease, unspecified
- G31.01Pick's disease
- G31.09Other frontotemporal neurocognitive disorder
- G31.81Alpers disease
- G31.82Leigh's disease
- G31.83Neurocognitive disorder with Lewy bodies
- G31.86Alexander disease
- G91.0Communicating hydrocephalus
- G91.1Obstructive hydrocephalus
- G91.2(Idiopathic) normal pressure hydrocephalus
- G91.3Post-traumatic hydrocephalus, unspecified
- G91.4Hydrocephalus in diseases classified elsewhere
- G91.8Other hydrocephalus
- G91.9Hydrocephalus, unspecified
- G93.7Reye's syndrome
- I67.3Progressive vascular leukoencephalopathy
Frequently asked questions
What is CMS-HCC V28 category 127?
HCC 127 is "Dementia, Mild or Unspecified", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 65 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 127?
The community non-dual aged relative factor for CMS-HCC V28 category 127 is 0.341. 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 127?
65 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 127 (Dementia, Mild or Unspecified) for payment year 2026.
Which categories trump HCC 127 in the V28 hierarchy?
HCC 127 is superseded by HCC 125 (Dementia, Severe), HCC 126 (Dementia, Moderate). When a more severe category in the same disease group is documented, it is counted instead of HCC 127.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.