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V28 HCC 298Community non-dual aged RAF 0.336

Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 298 carries a community non-dual aged RAF of 0.336, and 180 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: 0.336Community PBA: 0.327Community FBA: 0.323Community ND: 0.364Community PBD: 0.301Community FBD: 0.319Institutional: 0.545

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

ICD-10-CM codes that map to HCC 298 (180)

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

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A printable one-pager for HCC 298: 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 298?

HCC 298 is "Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 180 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 298?

The community non-dual aged relative factor for CMS-HCC V28 category 298 is 0.336. 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 298?

180 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 298 (Severe Diabetic Eye Disease, Retinal Vein Occlusion, and Vitreous Hemorrhage) for payment year 2026.

Related condition guides

In-depth HCC coding guides for conditions that map to category 298, 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.