V28 HCC 401Community non-dual aged RAF 0.522

Vertebral Fractures without Spinal Cord Injury

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 401 carries a community non-dual aged RAF of 0.522, and 339 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: 0.522Community PBA: 0.538Community FBA: 0.622Community ND: 0.605Community PBD: 0.412Community FBD: 0.559Institutional: 0.231

ICD-10-CM codes that map to HCC 401 (339)

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 401?

HCC 401 is "Vertebral Fractures without Spinal Cord Injury", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 339 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 401?

The community non-dual aged relative factor for CMS-HCC V28 category 401 is 0.522. 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 401?

339 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 401 (Vertebral Fractures without Spinal Cord Injury) for payment year 2026.

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