Myasthenia Gravis without (Acute) Exacerbation and Other Myoneural Disorders
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 196 carries a community non-dual aged RAF of 0.516, and 9 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 195 when a more severe category in the same disease group is also present.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 195 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 196 (9)
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.
- G70.00Myasthenia gravis without (acute) exacerbation
- G70.1Toxic myoneural disorders
- G70.2Congenital and developmental myasthenia
- G70.80Lambert-Eaton syndrome, unspecified
- G70.81Lambert-Eaton syndrome in disease classified elsewhere
- G70.89Other specified myoneural disorders
- G70.9Myoneural disorder, unspecified
- G73.1Lambert-Eaton syndrome in neoplastic disease
- G73.3Myasthenic syndromes in other diseases classified elsewhere
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 196?
HCC 196 is "Myasthenia Gravis without (Acute) Exacerbation and Other Myoneural Disorders", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 9 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 196?
The community non-dual aged relative factor for CMS-HCC V28 category 196 is 0.516. 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 196?
9 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 196 (Myasthenia Gravis without (Acute) Exacerbation and Other Myoneural Disorders) for payment year 2026.
Which categories trump HCC 196 in the V28 hierarchy?
HCC 196 is superseded by HCC 195 (Myasthenia Gravis with (Acute) Exacerbation). When a more severe category in the same disease group is documented, it is counted instead of HCC 196.
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.