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 carries a community non-dual aged RAF of 1.965, and 25 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.
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)
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.
- 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
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 payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 25 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 379?
The community non-dual aged relative factor for CMS-HCC V28 category 379 is 1.965. 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 379?
25 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) for payment year 2026.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.