Hemiplegia/Hemiparesis
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 253 carries a community non-dual aged RAF of 0.387, and 45 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 180, HCC 191, HCC 192 when a more severe category in the same disease group is also present.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.
V28 hierarchy
Trumped by: HCC 180, HCC 191, HCC 192 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 254 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 253 (45)
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.
- G81.00Flaccid hemiplegia affecting unspecified side
- G81.01Flaccid hemiplegia affecting right dominant side
- G81.02Flaccid hemiplegia affecting left dominant side
- G81.03Flaccid hemiplegia affecting right nondominant side
- G81.04Flaccid hemiplegia affecting left nondominant side
- G81.10Spastic hemiplegia affecting unspecified side
- G81.11Spastic hemiplegia affecting right dominant side
- G81.12Spastic hemiplegia affecting left dominant side
- G81.13Spastic hemiplegia affecting right nondominant side
- G81.14Spastic hemiplegia affecting left nondominant side
- G81.90Hemiplegia, unspecified affecting unspecified side
- G81.91Hemiplegia, unspecified affecting right dominant side
- G81.92Hemiplegia, unspecified affecting left dominant side
- G81.93Hemiplegia, unspecified affecting right nondominant side
- G81.94Hemiplegia, unspecified affecting left nondominant side
- I69.051Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right dominant side
- I69.052Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left dominant side
- I69.053Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side
- I69.054Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side
- I69.059Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting unspecified side
- I69.151Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side
- I69.152Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side
- I69.153Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side
- I69.154Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side
- I69.159Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspecified side
- I69.251Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right dominant side
- I69.252Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left dominant side
- I69.253Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right non-dominant side
- I69.254Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left non-dominant side
- I69.259Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting unspecified side
- I69.351Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side
- I69.352Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side
- I69.353Hemiplegia and hemiparesis following cerebral infarction affecting right non-dominant side
- I69.354Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side
- I69.359Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side
- I69.851Hemiplegia and hemiparesis following other cerebrovascular disease affecting right dominant side
- I69.852Hemiplegia and hemiparesis following other cerebrovascular disease affecting left dominant side
- I69.853Hemiplegia and hemiparesis following other cerebrovascular disease affecting right non-dominant side
- I69.854Hemiplegia and hemiparesis following other cerebrovascular disease affecting left non-dominant side
- I69.859Hemiplegia and hemiparesis following other cerebrovascular disease affecting unspecified side
- I69.951Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right dominant side
- I69.952Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left dominant side
- I69.953Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right non-dominant side
- I69.954Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side
- I69.959Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting unspecified side
Frequently asked questions
What is CMS-HCC V28 category 253?
HCC 253 is "Hemiplegia/Hemiparesis", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 45 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 253?
The community non-dual aged relative factor for CMS-HCC V28 category 253 is 0.387. 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 253?
45 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 253 (Hemiplegia/Hemiparesis) for payment year 2026.
Which categories trump HCC 253 in the V28 hierarchy?
HCC 253 is superseded by HCC 180 (Quadriplegia), HCC 191 (Quadriplegic Cerebral Palsy), HCC 192 (Cerebral Palsy, Except Quadriplegic). When a more severe category in the same disease group is documented, it is counted instead of HCC 253.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.