V28 HCC 2
Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 2 has a source-labeled community non-dual aged reference coefficient of 0.5, and 52 ICD-10-CM diagnosis codes appear in its official mapping.
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.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
ICD-10-CM codes that map to HCC 2 (52)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.
- A02.1Salmonella sepsis
- A20.7Septicemic plague
- A22.7Anthrax sepsis
- A26.7Erysipelothrix sepsis
- A32.7Listerial sepsis
- A39.2Acute meningococcemia
- A39.3Chronic meningococcemia
- A39.4Meningococcemia, unspecified
- A40.0Sepsis due to streptococcus, group A
- A40.1Sepsis due to streptococcus, group B
- A40.3Sepsis due to Streptococcus pneumoniae
- A40.8Other streptococcal sepsis
- A40.9Streptococcal sepsis, unspecified
- A41.01Sepsis due to Methicillin susceptible Staphylococcus aureus
- A41.02Sepsis due to Methicillin resistant Staphylococcus aureus
- A41.1Sepsis due to other specified staphylococcus
- A41.2Sepsis due to unspecified staphylococcus
- A41.3Sepsis due to Hemophilus influenzae
- A41.4Sepsis due to anaerobes
- A41.50Gram-negative sepsis, unspecified
- A41.51Sepsis due to Escherichia coli [E. coli]
- A41.52Sepsis due to Pseudomonas
- A41.53Sepsis due to Serratia
- A41.54Sepsis due to Acinetobacter baumannii
- A41.59Other Gram-negative sepsis
- A41.81Sepsis due to Enterococcus
- A41.89Other specified sepsis
- A41.9Sepsis, unspecified organism
- A42.7Actinomycotic sepsis
- A48.3Toxic shock syndrome
- A54.86Gonococcal sepsis
- B00.7Disseminated herpesviral disease
- B37.7Candidal sepsis
- M35.81Multisystem inflammatory syndrome
- P02.70Newborn affected by fetal inflammatory response syndrome
- P36.0Sepsis of newborn due to streptococcus, group B
- P36.10Sepsis of newborn due to unspecified streptococci
- P36.19Sepsis of newborn due to other streptococci
- P36.2Sepsis of newborn due to Staphylococcus aureus
- P36.30Sepsis of newborn due to unspecified staphylococci
- P36.39Sepsis of newborn due to other staphylococci
- P36.4Sepsis of newborn due to Escherichia coli
- P36.5Sepsis of newborn due to anaerobes
- P36.8Other bacterial sepsis of newborn
- P36.9Bacterial sepsis of newborn, unspecified
- R57.1Hypovolemic shock
- R57.8Other shock
- R65.10Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction
- R65.11Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction
- R65.20Severe sepsis without septic shock
- R65.21Severe sepsis with septic shock
- T79.4XXATraumatic shock, initial encounter
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 2?
HCC 2 is "Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 52 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 2?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 2 is 0.5. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 2?
52 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock) for payment year 2026.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and 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.