Skip to content
HCC Buddy home
V28 HCC 402Community non-dual aged RAF 0.467

Hip Fracture/Dislocation

Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 402 carries a community non-dual aged RAF of 0.467, and 729 payable ICD-10-CM diagnosis codes map to it.

Medically reviewed by Jess P., CPC · Reviewed: May 30, 2026

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: 0.467Community PBA: 0.499Community FBA: 0.561Community ND: 0.561Community PBD: 0.527Community FBD: 0.57Institutional: 0.089

Combine this factor with demographics and other HCCs in the RAF score calculator to model the full CMS-HCC V28 RAF for a member.

ICD-10-CM codes that map to HCC 402 (729)

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.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

A printable one-pager for HCC 402: which member codes risk-adjust, the RAF weight, and the MEAT your notes need to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

Frequently asked questions

What is CMS-HCC V28 category 402?

HCC 402 is "Hip Fracture/Dislocation", a payment Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 729 payable ICD-10-CM codes map to it.

What is the RAF weight for HCC 402?

The community non-dual aged relative factor for CMS-HCC V28 category 402 is 0.467. 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 402?

729 payable ICD-10-CM diagnosis codes map to CMS-HCC V28 category 402 (Hip Fracture/Dislocation) for payment year 2026.

Related references

Sources

CMS published ICD-10-CM mapping file plus 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.