V28 HCC 19Community non-dual aged RAF 1.798

Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 19 carries a community non-dual aged RAF of 1.798, and 68 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 17, HCC 18 when a more severe category in the same disease group is also present.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: 1.798Community PBA: 1.52Community FBA: 1.563Community ND: 1.989Community PBD: 1.554Community FBD: 1.661Institutional: 0.957

V28 hierarchy

Trumped by: HCC 17, HCC 18 (a more severe category in the same disease group supersedes this one).

Supersedes: HCC 20, HCC 21, HCC 22, HCC 23 (this category is counted instead of these when they co-occur).

ICD-10-CM codes that map to HCC 19 (68)

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 19?

HCC 19 is "Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 68 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 19?

The community non-dual aged relative factor for CMS-HCC V28 category 19 is 1.798. 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 19?

68 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers) for payment year 2026.

Which categories trump HCC 19 in the V28 hierarchy?

HCC 19 is superseded by HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic), HCC 18 (Cancer Metastatic to Bone, Other and Unspecified Metastatic Cancer; Acute Leukemia Except Myeloid). When a more severe category in the same disease group is documented, it is counted instead of HCC 19.

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