V28 HCC 380Community non-dual aged RAF 1.078
Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 380 carries a community non-dual aged RAF of 1.078, and 152 payable ICD-10-CM diagnosis codes map to it. In the V28 hierarchy it is superseded by HCC 379 when a more severe category in the same disease group is also present.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.
Community NA: 1.078Community PBA: 1.268Community FBA: 1.422Community ND: 1.091Community PBD: 1.378Community FBD: 1.285Institutional: 0.839
V28 hierarchy
Trumped by: HCC 379 (a more severe category in the same disease group supersedes this one).
Supersedes: 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 380 (152)
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.
- L97.103Non-pressure chronic ulcer of unspecified thigh with necrosis of muscle
- L97.104Non-pressure chronic ulcer of unspecified thigh with necrosis of bone
- L97.105Non-pressure chronic ulcer of unspecified thigh with muscle involvement without evidence of necrosis
- L97.106Non-pressure chronic ulcer of unspecified thigh with bone involvement without evidence of necrosis
- L97.113Non-pressure chronic ulcer of right thigh with necrosis of muscle
- L97.114Non-pressure chronic ulcer of right thigh with necrosis of bone
- L97.115Non-pressure chronic ulcer of right thigh with muscle involvement without evidence of necrosis
- L97.116Non-pressure chronic ulcer of right thigh with bone involvement without evidence of necrosis
- L97.123Non-pressure chronic ulcer of left thigh with necrosis of muscle
- L97.124Non-pressure chronic ulcer of left thigh with necrosis of bone
- L97.125Non-pressure chronic ulcer of left thigh with muscle involvement without evidence of necrosis
- L97.126Non-pressure chronic ulcer of left thigh with bone involvement without evidence of necrosis
- L97.203Non-pressure chronic ulcer of unspecified calf with necrosis of muscle
- L97.204Non-pressure chronic ulcer of unspecified calf with necrosis of bone
- L97.205Non-pressure chronic ulcer of unspecified calf with muscle involvement without evidence of necrosis
- L97.206Non-pressure chronic ulcer of unspecified calf with bone involvement without evidence of necrosis
- L97.213Non-pressure chronic ulcer of right calf with necrosis of muscle
- L97.214Non-pressure chronic ulcer of right calf with necrosis of bone
- L97.215Non-pressure chronic ulcer of right calf with muscle involvement without evidence of necrosis
- L97.216Non-pressure chronic ulcer of right calf with bone involvement without evidence of necrosis
- L97.223Non-pressure chronic ulcer of left calf with necrosis of muscle
- L97.224Non-pressure chronic ulcer of left calf with necrosis of bone
- L97.225Non-pressure chronic ulcer of left calf with muscle involvement without evidence of necrosis
- L97.226Non-pressure chronic ulcer of left calf with bone involvement without evidence of necrosis
- L97.303Non-pressure chronic ulcer of unspecified ankle with necrosis of muscle
- L97.304Non-pressure chronic ulcer of unspecified ankle with necrosis of bone
- L97.305Non-pressure chronic ulcer of unspecified ankle with muscle involvement without evidence of necrosis
- L97.306Non-pressure chronic ulcer of unspecified ankle with bone involvement without evidence of necrosis
- L97.313Non-pressure chronic ulcer of right ankle with necrosis of muscle
- L97.314Non-pressure chronic ulcer of right ankle with necrosis of bone
- L97.315Non-pressure chronic ulcer of right ankle with muscle involvement without evidence of necrosis
- L97.316Non-pressure chronic ulcer of right ankle with bone involvement without evidence of necrosis
- L97.323Non-pressure chronic ulcer of left ankle with necrosis of muscle
- L97.324Non-pressure chronic ulcer of left ankle with necrosis of bone
- L97.325Non-pressure chronic ulcer of left ankle with muscle involvement without evidence of necrosis
- L97.326Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis
- L97.403Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of muscle
- L97.404Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of bone
- L97.405Non-pressure chronic ulcer of unspecified heel and midfoot with muscle involvement without evidence of necrosis
- L97.406Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis
- L97.413Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle
- L97.414Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone
- L97.415Non-pressure chronic ulcer of right heel and midfoot with muscle involvement without evidence of necrosis
- L97.416Non-pressure chronic ulcer of right heel and midfoot with bone involvement without evidence of necrosis
- L97.423Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle
- L97.424Non-pressure chronic ulcer of left heel and midfoot with necrosis of bone
- L97.425Non-pressure chronic ulcer of left heel and midfoot with muscle involvement without evidence of necrosis
- L97.426Non-pressure chronic ulcer of left heel and midfoot with bone involvement without evidence of necrosis
- L97.503Non-pressure chronic ulcer of other part of unspecified foot with necrosis of muscle
- L97.504Non-pressure chronic ulcer of other part of unspecified foot with necrosis of bone
- L97.505Non-pressure chronic ulcer of other part of unspecified foot with muscle involvement without evidence of necrosis
- L97.506Non-pressure chronic ulcer of other part of unspecified foot with bone involvement without evidence of necrosis
- L97.513Non-pressure chronic ulcer of other part of right foot with necrosis of muscle
- L97.514Non-pressure chronic ulcer of other part of right foot with necrosis of bone
- L97.515Non-pressure chronic ulcer of other part of right foot with muscle involvement without evidence of necrosis
- L97.516Non-pressure chronic ulcer of other part of right foot with bone involvement without evidence of necrosis
- L97.523Non-pressure chronic ulcer of other part of left foot with necrosis of muscle
- L97.524Non-pressure chronic ulcer of other part of left foot with necrosis of bone
- L97.525Non-pressure chronic ulcer of other part of left foot with muscle involvement without evidence of necrosis
- L97.526Non-pressure chronic ulcer of other part of left foot with bone involvement without evidence of necrosis
- L97.803Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of muscle
- L97.804Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of bone
- L97.805Non-pressure chronic ulcer of other part of unspecified lower leg with muscle involvement without evidence of necrosis
- L97.806Non-pressure chronic ulcer of other part of unspecified lower leg with bone involvement without evidence of necrosis
- L97.813Non-pressure chronic ulcer of other part of right lower leg with necrosis of muscle
- L97.814Non-pressure chronic ulcer of other part of right lower leg with necrosis of bone
- L97.815Non-pressure chronic ulcer of other part of right lower leg with muscle involvement without evidence of necrosis
- L97.816Non-pressure chronic ulcer of other part of right lower leg with bone involvement without evidence of necrosis
- L97.823Non-pressure chronic ulcer of other part of left lower leg with necrosis of muscle
- L97.824Non-pressure chronic ulcer of other part of left lower leg with necrosis of bone
- L97.825Non-pressure chronic ulcer of other part of left lower leg with muscle involvement without evidence of necrosis
- L97.826Non-pressure chronic ulcer of other part of left lower leg with bone involvement without evidence of necrosis
- L97.903Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of muscle
- L97.904Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of bone
- L97.905Non-pressure chronic ulcer of unspecified part of unspecified lower leg with muscle involvement without evidence of necrosis
- L97.906Non-pressure chronic ulcer of unspecified part of unspecified lower leg with bone involvement without evidence of necrosis
- L97.913Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of muscle
- L97.914Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of bone
- L97.915Non-pressure chronic ulcer of unspecified part of right lower leg with muscle involvement without evidence of necrosis
- L97.916Non-pressure chronic ulcer of unspecified part of right lower leg with bone involvement without evidence of necrosis
- L97.923Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of muscle
- L97.924Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of bone
- L97.925Non-pressure chronic ulcer of unspecified part of left lower leg with muscle involvement without evidence of necrosis
- L97.926Non-pressure chronic ulcer of unspecified part of left lower leg with bone involvement without evidence of necrosis
- L98.413Non-pressure chronic ulcer of buttock with necrosis of muscle
- L98.414Non-pressure chronic ulcer of buttock with necrosis of bone
- L98.415Non-pressure chronic ulcer of buttock with muscle involvement without evidence of necrosis
- L98.416Non-pressure chronic ulcer of buttock with bone involvement without evidence of necrosis
- L98.423Non-pressure chronic ulcer of back with necrosis of muscle
- L98.424Non-pressure chronic ulcer of back with necrosis of bone
- L98.425Non-pressure chronic ulcer of back with muscle involvement without evidence of necrosis
- L98.426Non-pressure chronic ulcer of back with bone involvement without evidence of necrosis
- L98.433Non-pressure chronic ulcer of abdomen with necrosis of muscle
- L98.434Non-pressure chronic ulcer of abdomen with necrosis of bone
- L98.435Non-pressure chronic ulcer of abdomen with muscle involvement without evidence of necrosis
- L98.436Non-pressure chronic ulcer of abdomen with bone involvement without evidence of necrosis
- L98.443Non-pressure chronic ulcer of chest with necrosis of muscle
- L98.444Non-pressure chronic ulcer of chest with necrosis of bone
- L98.445Non-pressure chronic ulcer of chest with muscle involvement without evidence of necrosis
- L98.446Non-pressure chronic ulcer of chest with bone involvement without evidence of necrosis
- L98.453Non-pressure chronic ulcer of neck with necrosis of muscle
- L98.454Non-pressure chronic ulcer of neck with necrosis of bone
- L98.455Non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis
- L98.456Non-pressure chronic ulcer of neck with bone involvement without evidence of necrosis
- L98.463Non-pressure chronic ulcer of face with necrosis of muscle
- L98.464Non-pressure chronic ulcer of face with necrosis of bone
- L98.465Non-pressure chronic ulcer of face with muscle involvement without evidence of necrosis
- L98.466Non-pressure chronic ulcer of face with bone involvement without evidence of necrosis
- L98.473Non-pressure chronic ulcer of groin with necrosis of muscle
- L98.474Non-pressure chronic ulcer of groin with necrosis of bone
- L98.475Non-pressure chronic ulcer of groin with muscle involvement without evidence of necrosis
- L98.476Non-pressure chronic ulcer of groin with bone involvement without evidence of necrosis
- L98.493Non-pressure chronic ulcer of skin of other sites with necrosis of muscle
- L98.494Non-pressure chronic ulcer of skin of other sites with necrosis of bone
- L98.495Non-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis
- L98.496Non-pressure chronic ulcer of skin of other sites with bone involvement without evidence of necrosis
- L98.A113Non-pressure chronic ulcer of right upper arm with necrosis of muscle
- L98.A114Non-pressure chronic ulcer of right upper arm with necrosis of bone
- L98.A115Non-pressure chronic ulcer of right upper arm with muscle involvement without evidence of necrosis
- L98.A116Non-pressure chronic ulcer of right upper arm with bone involvement without evidence of necrosis
- L98.A123Non-pressure chronic ulcer of left upper arm with necrosis of muscle
- L98.A124Non-pressure chronic ulcer of left upper arm with necrosis of bone
- L98.A125Non-pressure chronic ulcer of left upper arm with muscle involvement without evidence of necrosis
- L98.A126Non-pressure chronic ulcer of left upper arm with bone involvement without evidence of necrosis
- L98.A193Non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle
- L98.A194Non-pressure chronic ulcer of unspecified upper arm with necrosis of bone
- L98.A195Non-pressure chronic ulcer of unspecified upper arm with muscle involvement without evidence of necrosis
- L98.A196Non-pressure chronic ulcer of unspecified upper arm with bone involvement without evidence of necrosis
- L98.A213Non-pressure chronic ulcer of right forearm with necrosis of muscle
- L98.A214Non-pressure chronic ulcer of right forearm with necrosis of bone
- L98.A215Non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis
- L98.A216Non-pressure chronic ulcer of right forearm with bone involvement without evidence of necrosis
- L98.A223Non-pressure chronic ulcer of left forearm with necrosis of muscle
- L98.A224Non-pressure chronic ulcer of left forearm with necrosis of bone
- L98.A225Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis
- L98.A226Non-pressure chronic ulcer of left forearm with bone involvement without evidence of necrosis
- L98.A293Non-pressure chronic ulcer of unspecified forearm with necrosis of muscle
- L98.A294Non-pressure chronic ulcer of unspecified forearm with necrosis of bone
- L98.A295Non-pressure chronic ulcer of unspecified forearm with muscle involvement without evidence of necrosis
- L98.A296Non-pressure chronic ulcer of unspecified forearm with bone involvement without evidence of necrosis
- L98.A313Non-pressure chronic ulcer of right hand with necrosis of muscle
- L98.A314Non-pressure chronic ulcer of right hand with necrosis of bone
- L98.A315Non-pressure chronic ulcer of right hand with muscle involvement without evidence of necrosis
- L98.A316Non-pressure chronic ulcer of right hand with bone involvement without evidence of necrosis
- L98.A323Non-pressure chronic ulcer of left hand with necrosis of muscle
- L98.A324Non-pressure chronic ulcer of left hand with necrosis of bone
- L98.A325Non-pressure chronic ulcer of left hand with muscle involvement without evidence of necrosis
- L98.A326Non-pressure chronic ulcer of left hand with bone involvement without evidence of necrosis
- L98.A393Non-pressure chronic ulcer of unspecified hand with necrosis of muscle
- L98.A394Non-pressure chronic ulcer of unspecified hand with necrosis of bone
- L98.A395Non-pressure chronic ulcer of unspecified hand with muscle involvement without evidence of necrosis
- L98.A396Non-pressure chronic ulcer of unspecified hand with bone involvement without evidence of necrosis
Frequently asked questions
What is CMS-HCC V28 category 380?
HCC 380 is "Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 152 payable ICD-10-CM codes map to it.
What is the RAF weight for HCC 380?
The community non-dual aged relative factor for CMS-HCC V28 category 380 is 1.078. 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 380?
152 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) for payment year 2026.
Which categories trump HCC 380 in the V28 hierarchy?
HCC 380 is superseded by HCC 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone). When a more severe category in the same disease group is documented, it is counted instead of HCC 380.
Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.