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V28 HCC 263Community non-dual aged RAF 1.118

Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 263 carries a community non-dual aged RAF of 1.118, and 127 payable ICD-10-CM diagnosis codes map to it.

Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026

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: 1.118Community PBA: 1.007Community FBA: 1.432Community ND: 1.066Community PBD: 1.056Community FBD: 1.276Institutional: 0.696

Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.

V28 hierarchy

Supersedes: HCC 264, HCC 383, HCC 409 (this category is counted instead of these when they co-occur).

ICD-10-CM codes that map to HCC 263 (127)

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.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

A printable one-pager for HCC 263: which member codes risk-adjust, the RAF weight, and the MEAT your notes need to make it stick. Free, no card.

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Frequently asked questions

What is CMS-HCC V28 category 263?

HCC 263 is "Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 127 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 263?

The community non-dual aged relative factor for CMS-HCC V28 category 263 is 1.118. 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 263?

127 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene) for payment year 2026.

Related condition guides

In-depth HCC coding guides for conditions that map to category 263, with documentation tips, common mistakes, and the V24-to-V28 changes.

Related references

Sources

CMS published ICD-10-CM mapping file plus 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.