V28 HCC 20Community non-dual aged RAF 1.136

Lung and Other Severe Cancers

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 20 carries a community non-dual aged RAF of 1.136, and 233 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 17, HCC 18, HCC 19 when a more severe category in the same disease group is also present.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: 1.136Community PBA: 1.214Community FBA: 1.166Community ND: 0.978Community PBD: 1.067Community FBD: 1.173Institutional: 0.672

V28 hierarchy

Trumped by: HCC 17, HCC 18, HCC 19 (a more severe category in the same disease group supersedes this one).

Supersedes: 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 20 (233)

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 20?

HCC 20 is "Lung and Other Severe Cancers", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 233 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 20?

The community non-dual aged relative factor for CMS-HCC V28 category 20 is 1.136. 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 20?

233 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 20 (Lung and Other Severe Cancers) for payment year 2026.

Which categories trump HCC 20 in the V28 hierarchy?

HCC 20 is superseded by HCC 17 (Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic), HCC 18 (Cancer Metastatic to Bone, Other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), HCC 19 (Myelodysplastic Syndromes, Multiple Myeloma, and Other Cancers). When a more severe category in the same disease group is documented, it is counted instead of HCC 20.

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