V28 HCC 379
Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 379 has a source-labeled community non-dual aged reference coefficient of 1.965, and 25 ICD-10-CM diagnosis codes appear in its official mapping.
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
Supersedes: HCC 380, HCC 381, HCC 382, HCC 383 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 379 (25)
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.
- L89.004Pressure ulcer of unspecified elbow, stage 4
- L89.014Pressure ulcer of right elbow, stage 4
- L89.024Pressure ulcer of left elbow, stage 4
- L89.104Pressure ulcer of unspecified part of back, stage 4
- L89.114Pressure ulcer of right upper back, stage 4
- L89.124Pressure ulcer of left upper back, stage 4
- L89.134Pressure ulcer of right lower back, stage 4
- L89.144Pressure ulcer of left lower back, stage 4
- L89.154Pressure ulcer of sacral region, stage 4
- L89.204Pressure ulcer of unspecified hip, stage 4
- L89.214Pressure ulcer of right hip, stage 4
- L89.224Pressure ulcer of left hip, stage 4
- L89.304Pressure ulcer of unspecified buttock, stage 4
- L89.314Pressure ulcer of right buttock, stage 4
- L89.324Pressure ulcer of left buttock, stage 4
- L89.44Pressure ulcer of contiguous site of back, buttock and hip, stage 4
- L89.504Pressure ulcer of unspecified ankle, stage 4
- L89.514Pressure ulcer of right ankle, stage 4
- L89.524Pressure ulcer of left ankle, stage 4
- L89.604Pressure ulcer of unspecified heel, stage 4
- L89.614Pressure ulcer of right heel, stage 4
- L89.624Pressure ulcer of left heel, stage 4
- L89.814Pressure ulcer of head, stage 4
- L89.894Pressure ulcer of other site, stage 4
- L89.94Pressure ulcer of unspecified site, stage 4
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 379?
HCC 379 is "Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 25 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 379?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 379 is 1.965. 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 379?
25 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) for payment year 2026.
Related condition guides
In-depth HCC coding guides for conditions that map to category 379, 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.