V28 HCC 264
Vascular Disease with Complications
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 264 has a source-labeled community non-dual aged reference coefficient of 0.455, and 71 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 263 when a more severe category in the same disease group is also present.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.
V28 hierarchy
Trumped by: HCC 263 (a more severe category in the same disease group supersedes this one).
ICD-10-CM codes that map to HCC 264 (71)
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.
- I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg
- I70.222Atherosclerosis of native arteries of extremities with rest pain, left leg
- I70.223Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
- I70.228Atherosclerosis of native arteries of extremities with rest pain, other extremity
- I70.229Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
- I70.321Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, right leg
- I70.322Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, left leg
- I70.323Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, bilateral legs
- I70.328Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, other extremity
- I70.329Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, unspecified extremity
- I70.421Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, right leg
- I70.422Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, left leg
- I70.423Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, bilateral legs
- I70.428Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, other extremity
- I70.429Atherosclerosis of autologous vein bypass graft(s) of the extremities with rest pain, unspecified extremity
- I70.521Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, right leg
- I70.522Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, left leg
- I70.523Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, bilateral legs
- I70.528Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, other extremity
- I70.529Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with rest pain, unspecified extremity
- I70.621Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, right leg
- I70.622Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, left leg
- I70.623Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, bilateral legs
- I70.628Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, other extremity
- I70.629Atherosclerosis of nonbiological bypass graft(s) of the extremities with rest pain, unspecified extremity
- I70.721Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, right leg
- I70.722Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, left leg
- I70.723Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, bilateral legs
- I70.728Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, other extremity
- I70.729Atherosclerosis of other type of bypass graft(s) of the extremities with rest pain, unspecified extremity
- I71.00Dissection of unspecified site of aorta
- I71.010Dissection of ascending aorta
- I71.011Dissection of aortic arch
- I71.012Dissection of descending thoracic aorta
- I71.019Dissection of thoracic aorta, unspecified
- I71.02Dissection of abdominal aorta
- I71.03Dissection of thoracoabdominal aorta
- I71.10Thoracic aortic aneurysm, ruptured, unspecified
- I71.11Aneurysm of the ascending aorta, ruptured
- I71.12Aneurysm of the aortic arch, ruptured
- I71.13Aneurysm of the descending thoracic aorta, ruptured
- I71.30Abdominal aortic aneurysm, ruptured, unspecified
- I71.31Pararenal abdominal aortic aneurysm, ruptured
- I71.32Juxtarenal abdominal aortic aneurysm, ruptured
- I71.33Infrarenal abdominal aortic aneurysm, ruptured
- I71.50Thoracoabdominal aortic aneurysm, ruptured, unspecified
- I71.51Supraceliac aneurysm of the thoracoabdominal aorta, ruptured
- I71.52Paravisceral aneurysm of the thoracoabdominal aorta, ruptured
- I71.8Aortic aneurysm of unspecified site, ruptured
- I74.01Saddle embolus of abdominal aorta
- I74.09Other arterial embolism and thrombosis of abdominal aorta
- I74.10Embolism and thrombosis of unspecified parts of aorta
- I74.11Embolism and thrombosis of thoracic aorta
- I74.19Embolism and thrombosis of other parts of aorta
- I74.2Embolism and thrombosis of arteries of the upper extremities
- I74.3Embolism and thrombosis of arteries of the lower extremities
- I74.4Embolism and thrombosis of arteries of extremities, unspecified
- I74.5Embolism and thrombosis of iliac artery
- I74.8Embolism and thrombosis of other arteries
- I74.9Embolism and thrombosis of unspecified artery
- I75.011Atheroembolism of right upper extremity
- I75.012Atheroembolism of left upper extremity
- I75.013Atheroembolism of bilateral upper extremities
- I75.019Atheroembolism of unspecified upper extremity
- I75.021Atheroembolism of right lower extremity
- I75.022Atheroembolism of left lower extremity
- I75.023Atheroembolism of bilateral lower extremities
- I75.029Atheroembolism of unspecified lower extremity
- I75.81Atheroembolism of kidney
- I75.89Atheroembolism of other site
- I76Septic arterial embolism
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 264?
HCC 264 is "Vascular Disease with Complications", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 71 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 264?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 264 is 0.455. 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 264?
71 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 264 (Vascular Disease with Complications) for payment year 2026.
Which categories trump HCC 264 in the V28 hierarchy?
HCC 264 is superseded by HCC 263 (Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene). When a more severe category in the same disease group is documented, it is counted instead of HCC 264.
Related condition guides
In-depth HCC coding guides for conditions that map to category 264, with documentation tips, common mistakes, and the V24-to-V28 changes.
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.