V28 HCC 223
Heart Assist Device/Artificial Heart
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 223 has a source-labeled community non-dual aged reference coefficient of 2.505, and 6 ICD-10-CM diagnosis codes appear in its official mapping. CMS-HCC V28 HCC 223 receives credit only when the member also has an ICD-10-CM code mapping to HCC 221, 222, 224, 225, or 226. In the V28 hierarchy it is superseded by HCC 221, HCC 222 when a more severe category in the same disease group is also present.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.
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.
CMS-HCC V28 HCC 223 receives credit only when the member also has an ICD-10-CM code mapping to HCC 221, 222, 224, 225, or 226.
V28 hierarchy
Trumped by: HCC 221, HCC 222 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 224, HCC 225, HCC 226, HCC 227 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 223 (6)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. CMS-HCC V28 HCC 223 receives credit only when the member also has an ICD-10-CM code mapping to HCC 221, 222, 224, 225, or 226. Open any code for its full description and coding guidance.
- T82.512ABreakdown (mechanical) of artificial heart, initial encounter
- T82.522ADisplacement of artificial heart, initial encounter
- T82.532ALeakage of artificial heart, initial encounter
- T82.592AOther mechanical complication of artificial heart, initial encounter
- Z95.811Presence of heart assist device
- Z95.812Presence of fully implantable artificial heart
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
A printable reference for HCC 223: representative mapping rows and MEAT reminders. Free, no card.
Free PDF. No card. Unsubscribe anytime.
Frequently asked questions
What is CMS-HCC V28 category 223?
HCC 223 is "Heart Assist Device/Artificial Heart", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 6 ICD-10-CM codes appear in its official mapping. CMS-HCC V28 HCC 223 receives credit only when the member also has an ICD-10-CM code mapping to HCC 221, 222, 224, 225, or 226.
What reference coefficient is published for HCC 223?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 223 is 2.505. CMS-HCC V28 HCC 223 receives credit only when the member also has an ICD-10-CM code mapping to HCC 221, 222, 224, 225, or 226. 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 223?
6 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 223 (Heart Assist Device/Artificial Heart) for payment year 2026. CMS-HCC V28 HCC 223 receives credit only when the member also has an ICD-10-CM code mapping to HCC 221, 222, 224, 225, or 226.
Which categories trump HCC 223 in the V28 hierarchy?
HCC 223 is superseded by HCC 221 (Heart Transplant Status/Complications), HCC 222 (End Stage Heart Failure). When a more severe category in the same disease group is documented, it is counted instead of HCC 223.
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 August 25, 2026.