Paraplegia
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 181 carries a community non-dual aged RAF of 0.942, and 18 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 180, HCC 191, HCC 192 when a more severe category in the same disease group is also present.
Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026
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.
Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.
V28 hierarchy
Trumped by: HCC 180, HCC 191, HCC 192 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 182, HCC 254 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 181 (18)
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.
- G82.20Paraplegia, unspecified
- G82.21Paraplegia, complete
- G82.22Paraplegia, incomplete
- S24.111AComplete lesion at T1 level of thoracic spinal cord, initial encounter
- S24.111DComplete lesion at T1 level of thoracic spinal cord, subsequent encounter
- S24.111SComplete lesion at T1 level of thoracic spinal cord, sequela
- S24.112AComplete lesion at T2-T6 level of thoracic spinal cord, initial encounter
- S24.112DComplete lesion at T2-T6 level of thoracic spinal cord, subsequent encounter
- S24.112SComplete lesion at T2-T6 level of thoracic spinal cord, sequela
- S24.113AComplete lesion at T7-T10 level of thoracic spinal cord, initial encounter
- S24.113DComplete lesion at T7-T10 level of thoracic spinal cord, subsequent encounter
- S24.113SComplete lesion at T7-T10 level of thoracic spinal cord, sequela
- S24.114AComplete lesion at T11-T12 level of thoracic spinal cord, initial encounter
- S24.114DComplete lesion at T11-T12 level of thoracic spinal cord, subsequent encounter
- S24.114SComplete lesion at T11-T12 level of thoracic spinal cord, sequela
- S24.119AComplete lesion at unspecified level of thoracic spinal cord, initial encounter
- S24.119DComplete lesion at unspecified level of thoracic spinal cord, subsequent encounter
- S24.119SComplete lesion at unspecified level of thoracic spinal cord, sequela
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 181?
HCC 181 is "Paraplegia", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 18 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 181?
The community non-dual aged relative factor for CMS-HCC V28 category 181 is 0.942. 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 181?
18 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 181 (Paraplegia) for payment year 2026.
Which categories trump HCC 181 in the V28 hierarchy?
HCC 181 is superseded by HCC 180 (Quadriplegia), HCC 191 (Quadriplegic Cerebral Palsy), HCC 192 (Cerebral Palsy, Except Quadriplegic). When a more severe category in the same disease group is documented, it is counted instead of HCC 181.
Related references
Sources
CMS published ICD-10-CM mapping file plus 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.