Deep Vein Thrombosis and Pulmonary Embolism
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 267 carries a community non-dual aged RAF of 0.294, and 167 payable ICD-10-CM diagnosis codes map to it.
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.
ICD-10-CM codes that map to HCC 267 (167)
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.
- I26.01Septic pulmonary embolism with acute cor pulmonale
- I26.02Saddle embolus of pulmonary artery with acute cor pulmonale
- I26.03Cement embolism of pulmonary artery with acute cor pulmonale
- I26.04Fat embolism of pulmonary artery with acute cor pulmonale
- I26.09Other pulmonary embolism with acute cor pulmonale
- I26.90Septic pulmonary embolism without acute cor pulmonale
- I26.92Saddle embolus of pulmonary artery without acute cor pulmonale
- I26.93Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
- I26.94Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
- I26.95Cement embolism of pulmonary artery without acute cor pulmonale
- I26.96Fat embolism of pulmonary artery without acute cor pulmonale
- I26.99Other pulmonary embolism without acute cor pulmonale
- I27.82Chronic pulmonary embolism
- I80.10Phlebitis and thrombophlebitis of unspecified femoral vein
- I80.11Phlebitis and thrombophlebitis of right femoral vein
- I80.12Phlebitis and thrombophlebitis of left femoral vein
- I80.13Phlebitis and thrombophlebitis of femoral vein, bilateral
- I80.201Phlebitis and thrombophlebitis of unspecified deep vessels of right lower extremity
- I80.202Phlebitis and thrombophlebitis of unspecified deep vessels of left lower extremity
- I80.203Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities, bilateral
- I80.209Phlebitis and thrombophlebitis of unspecified deep vessels of unspecified lower extremity
- I80.211Phlebitis and thrombophlebitis of right iliac vein
- I80.212Phlebitis and thrombophlebitis of left iliac vein
- I80.213Phlebitis and thrombophlebitis of iliac vein, bilateral
- I80.219Phlebitis and thrombophlebitis of unspecified iliac vein
- I80.221Phlebitis and thrombophlebitis of right popliteal vein
- I80.222Phlebitis and thrombophlebitis of left popliteal vein
- I80.223Phlebitis and thrombophlebitis of popliteal vein, bilateral
- I80.229Phlebitis and thrombophlebitis of unspecified popliteal vein
- I80.231Phlebitis and thrombophlebitis of right tibial vein
- I80.232Phlebitis and thrombophlebitis of left tibial vein
- I80.233Phlebitis and thrombophlebitis of tibial vein, bilateral
- I80.239Phlebitis and thrombophlebitis of unspecified tibial vein
- I80.241Phlebitis and thrombophlebitis of right peroneal vein
- I80.242Phlebitis and thrombophlebitis of left peroneal vein
- I80.243Phlebitis and thrombophlebitis of peroneal vein, bilateral
- I80.249Phlebitis and thrombophlebitis of unspecified peroneal vein
- I80.251Phlebitis and thrombophlebitis of right calf muscular vein
- I80.252Phlebitis and thrombophlebitis of left calf muscular vein
- I80.253Phlebitis and thrombophlebitis of calf muscular vein, bilateral
- I80.259Phlebitis and thrombophlebitis of unspecified calf muscular vein
- I80.291Phlebitis and thrombophlebitis of other deep vessels of right lower extremity
- I80.292Phlebitis and thrombophlebitis of other deep vessels of left lower extremity
- I80.293Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral
- I80.299Phlebitis and thrombophlebitis of other deep vessels of unspecified lower extremity
- I82.0Budd-Chiari syndrome
- I82.210Acute embolism and thrombosis of superior vena cava
- I82.211Chronic embolism and thrombosis of superior vena cava
- I82.220Acute embolism and thrombosis of inferior vena cava
- I82.221Chronic embolism and thrombosis of inferior vena cava
- I82.290Acute embolism and thrombosis of other thoracic veins
- I82.291Chronic embolism and thrombosis of other thoracic veins
- I82.3Embolism and thrombosis of renal vein
- I82.401Acute embolism and thrombosis of unspecified deep veins of right lower extremity
- I82.402Acute embolism and thrombosis of unspecified deep veins of left lower extremity
- I82.403Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral
- I82.409Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity
- I82.411Acute embolism and thrombosis of right femoral vein
- I82.412Acute embolism and thrombosis of left femoral vein
- I82.413Acute embolism and thrombosis of femoral vein, bilateral
- I82.419Acute embolism and thrombosis of unspecified femoral vein
- I82.421Acute embolism and thrombosis of right iliac vein
- I82.422Acute embolism and thrombosis of left iliac vein
- I82.423Acute embolism and thrombosis of iliac vein, bilateral
- I82.429Acute embolism and thrombosis of unspecified iliac vein
- I82.431Acute embolism and thrombosis of right popliteal vein
- I82.432Acute embolism and thrombosis of left popliteal vein
- I82.433Acute embolism and thrombosis of popliteal vein, bilateral
- I82.439Acute embolism and thrombosis of unspecified popliteal vein
- I82.441Acute embolism and thrombosis of right tibial vein
- I82.442Acute embolism and thrombosis of left tibial vein
- I82.443Acute embolism and thrombosis of tibial vein, bilateral
- I82.449Acute embolism and thrombosis of unspecified tibial vein
- I82.451Acute embolism and thrombosis of right peroneal vein
- I82.452Acute embolism and thrombosis of left peroneal vein
- I82.453Acute embolism and thrombosis of peroneal vein, bilateral
- I82.459Acute embolism and thrombosis of unspecified peroneal vein
- I82.461Acute embolism and thrombosis of right calf muscular vein
- I82.462Acute embolism and thrombosis of left calf muscular vein
- I82.463Acute embolism and thrombosis of calf muscular vein, bilateral
- I82.469Acute embolism and thrombosis of unspecified calf muscular vein
- I82.491Acute embolism and thrombosis of other specified deep vein of right lower extremity
- I82.492Acute embolism and thrombosis of other specified deep vein of left lower extremity
- I82.493Acute embolism and thrombosis of other specified deep vein of lower extremity, bilateral
- I82.499Acute embolism and thrombosis of other specified deep vein of unspecified lower extremity
- I82.4Y1Acute embolism and thrombosis of unspecified deep veins of right proximal lower extremity
- I82.4Y2Acute embolism and thrombosis of unspecified deep veins of left proximal lower extremity
- I82.4Y3Acute embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral
- I82.4Y9Acute embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity
- I82.4Z1Acute embolism and thrombosis of unspecified deep veins of right distal lower extremity
- I82.4Z2Acute embolism and thrombosis of unspecified deep veins of left distal lower extremity
- I82.4Z3Acute embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral
- I82.4Z9Acute embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity
- I82.501Chronic embolism and thrombosis of unspecified deep veins of right lower extremity
- I82.502Chronic embolism and thrombosis of unspecified deep veins of left lower extremity
- I82.503Chronic embolism and thrombosis of unspecified deep veins of lower extremity, bilateral
- I82.509Chronic embolism and thrombosis of unspecified deep veins of unspecified lower extremity
- I82.511Chronic embolism and thrombosis of right femoral vein
- I82.512Chronic embolism and thrombosis of left femoral vein
- I82.513Chronic embolism and thrombosis of femoral vein, bilateral
- I82.519Chronic embolism and thrombosis of unspecified femoral vein
- I82.521Chronic embolism and thrombosis of right iliac vein
- I82.522Chronic embolism and thrombosis of left iliac vein
- I82.523Chronic embolism and thrombosis of iliac vein, bilateral
- I82.529Chronic embolism and thrombosis of unspecified iliac vein
- I82.531Chronic embolism and thrombosis of right popliteal vein
- I82.532Chronic embolism and thrombosis of left popliteal vein
- I82.533Chronic embolism and thrombosis of popliteal vein, bilateral
- I82.539Chronic embolism and thrombosis of unspecified popliteal vein
- I82.541Chronic embolism and thrombosis of right tibial vein
- I82.542Chronic embolism and thrombosis of left tibial vein
- I82.543Chronic embolism and thrombosis of tibial vein, bilateral
- I82.549Chronic embolism and thrombosis of unspecified tibial vein
- I82.551Chronic embolism and thrombosis of right peroneal vein
- I82.552Chronic embolism and thrombosis of left peroneal vein
- I82.553Chronic embolism and thrombosis of peroneal vein, bilateral
- I82.559Chronic embolism and thrombosis of unspecified peroneal vein
- I82.561Chronic embolism and thrombosis of right calf muscular vein
- I82.562Chronic embolism and thrombosis of left calf muscular vein
- I82.563Chronic embolism and thrombosis of calf muscular vein, bilateral
- I82.569Chronic embolism and thrombosis of unspecified calf muscular vein
- I82.591Chronic embolism and thrombosis of other specified deep vein of right lower extremity
- I82.592Chronic embolism and thrombosis of other specified deep vein of left lower extremity
- I82.593Chronic embolism and thrombosis of other specified deep vein of lower extremity, bilateral
- I82.599Chronic embolism and thrombosis of other specified deep vein of unspecified lower extremity
- I82.5Y1Chronic embolism and thrombosis of unspecified deep veins of right proximal lower extremity
- I82.5Y2Chronic embolism and thrombosis of unspecified deep veins of left proximal lower extremity
- I82.5Y3Chronic embolism and thrombosis of unspecified deep veins of proximal lower extremity, bilateral
- I82.5Y9Chronic embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity
- I82.5Z1Chronic embolism and thrombosis of unspecified deep veins of right distal lower extremity
- I82.5Z2Chronic embolism and thrombosis of unspecified deep veins of left distal lower extremity
- I82.5Z3Chronic embolism and thrombosis of unspecified deep veins of distal lower extremity, bilateral
- I82.5Z9Chronic embolism and thrombosis of unspecified deep veins of unspecified distal lower extremity
- I82.621Acute embolism and thrombosis of deep veins of right upper extremity
- I82.622Acute embolism and thrombosis of deep veins of left upper extremity
- I82.623Acute embolism and thrombosis of deep veins of upper extremity, bilateral
- I82.629Acute embolism and thrombosis of deep veins of unspecified upper extremity
- I82.721Chronic embolism and thrombosis of deep veins of right upper extremity
- I82.722Chronic embolism and thrombosis of deep veins of left upper extremity
- I82.723Chronic embolism and thrombosis of deep veins of upper extremity, bilateral
- I82.729Chronic embolism and thrombosis of deep veins of unspecified upper extremity
- I82.A11Acute embolism and thrombosis of right axillary vein
- I82.A12Acute embolism and thrombosis of left axillary vein
- I82.A13Acute embolism and thrombosis of axillary vein, bilateral
- I82.A19Acute embolism and thrombosis of unspecified axillary vein
- I82.A21Chronic embolism and thrombosis of right axillary vein
- I82.A22Chronic embolism and thrombosis of left axillary vein
- I82.A23Chronic embolism and thrombosis of axillary vein, bilateral
- I82.A29Chronic embolism and thrombosis of unspecified axillary vein
- I82.B11Acute embolism and thrombosis of right subclavian vein
- I82.B12Acute embolism and thrombosis of left subclavian vein
- I82.B13Acute embolism and thrombosis of subclavian vein, bilateral
- I82.B19Acute embolism and thrombosis of unspecified subclavian vein
- I82.B21Chronic embolism and thrombosis of right subclavian vein
- I82.B22Chronic embolism and thrombosis of left subclavian vein
- I82.B23Chronic embolism and thrombosis of subclavian vein, bilateral
- I82.B29Chronic embolism and thrombosis of unspecified subclavian vein
- I82.C11Acute embolism and thrombosis of right internal jugular vein
- I82.C12Acute embolism and thrombosis of left internal jugular vein
- I82.C13Acute embolism and thrombosis of internal jugular vein, bilateral
- I82.C19Acute embolism and thrombosis of unspecified internal jugular vein
- I82.C21Chronic embolism and thrombosis of right internal jugular vein
- I82.C22Chronic embolism and thrombosis of left internal jugular vein
- I82.C23Chronic embolism and thrombosis of internal jugular vein, bilateral
- I82.C29Chronic embolism and thrombosis of unspecified internal jugular vein
- T79.0XXAAir embolism (traumatic), initial encounter
- T79.1XXAFat embolism (traumatic), initial encounter
Frequently asked questions
What is CMS-HCC V28 category 267?
HCC 267 is "Deep Vein Thrombosis and Pulmonary Embolism", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 167 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 267?
The community non-dual aged relative factor for CMS-HCC V28 category 267 is 0.294. 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 267?
167 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 267 (Deep Vein Thrombosis and Pulmonary Embolism) for payment year 2026.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.