Skip to content
V28 HCC 385Community non-dual aged RAF 1.291

Severe Skin Burn or Condition

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 385 carries a community non-dual aged RAF of 1.291, and 90 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.

Community NA: 1.291Community PBA: 0Community FBA: 2.362Community ND: 0.234Community PBD: 0.204Community FBD: 0.857Institutional: 0

ICD-10-CM codes that map to HCC 385 (90)

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.

Frequently asked questions

What is CMS-HCC V28 category 385?

HCC 385 is "Severe Skin Burn or Condition", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 90 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 385?

The community non-dual aged relative factor for CMS-HCC V28 category 385 is 1.291. 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 385?

90 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 385 (Severe Skin Burn or Condition) for payment year 2026.

Source: CMS published ICD-10-CM mapping file plus CMS-HCC v28 PY2026 model software.