V28 HCC 2Community non-dual aged RAF 0.5

Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 2 carries a community non-dual aged RAF of 0.5, and 52 payable ICD-10-CM diagnosis codes map to it.

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: 0.5Community PBA: 0.447Community FBA: 0.649Community ND: 0.598Community PBD: 0.591Community FBD: 0.78Institutional: 0.605

ICD-10-CM codes that map to HCC 2 (52)

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 2?

HCC 2 is "Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 52 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 2?

The community non-dual aged relative factor for CMS-HCC V28 category 2 is 0.5. 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 2?

52 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock) for payment year 2026.

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